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Reeve HK, Pfennig DW. Evolution of transmissible cancers: An adaptive, plastic strategy of selfish genetic elements? iScience 2024; 27:110740. [PMID: 39286496 PMCID: PMC11402641 DOI: 10.1016/j.isci.2024.110740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2024] Open
Abstract
A growing number of studies have applied evolutionary and ecological principles to understanding cancer. However, few such studies have examined whether phenotypic plasticity--the ability of a single individual or genome to respond differently to different environmental circumstances--can impact the origin and spread of cancer. Here, we propose the adaptive horizontal transmission hypothesis to explain how flexible decision-making by selfish genetic elements can cause them to spread from the genome of their original host into the genomes of other hosts through the evolution of transmissible cancers. Specifically, we hypothesize that such cancers appear when the likelihood of successful vertical transmission is sufficiently low relative to the likelihood of successful horizontal transmission. We develop an evolutionary optimization model of this hypothesis, highlight empirical findings that support it, and offer suggestions for future research. Generally, phenotypically plastic selfish genetic elements might play an important role in the evolution of transmissible cancers.
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Affiliation(s)
- Hudson Kern Reeve
- Department of Neurobiology and Behavior, Seeley G. Mudd Hall, Cornell University, Ithaca, NY 14853, USA
| | - David W Pfennig
- Department of Biology, CB#3280, Coker Hall, University of North Carolina, Chapel Hill, NC 27599-3280, USA
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Botelho BJS, Brito WRDS, Pereira Neto GDS, Gonçalves JSS, Oliveira BMS, de Oliveira CMC, de Lima ACR, Lima SS, Pinheiro PDNQ, Freitas FB, Guerreiro JF, Ishak R, Vallinoto ACR, Cayres Vallinoto IMV. Molecular and Phylogenetic Evidence of Interfamilial Transmission of HTLV-1 in the Afro-Descendant Community of São José de Icatú in the Brazilian Amazon. Viruses 2024; 16:1290. [PMID: 39205264 PMCID: PMC11360191 DOI: 10.3390/v16081290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Revised: 07/27/2024] [Accepted: 08/12/2024] [Indexed: 09/04/2024] Open
Abstract
This study aimed to describe the prevalence of HTLV-1/2 in quilombola communities in the state of Pará and investigate the possible sociodemographic risk factors associated with the infection, as well as to trace the occurrence of the familial transmission of the virus. A total of 310 individuals living in eight quilombos located in the state of Pará (northern Brazil) were investigated for the presence of anti-HTLV-1/2 antibodies using an enzyme-linked immunosorbent assay (ELISA), and positive samples were confirmed using Western blot and/or real-time quantitative polymerase chain reaction (qPCR). Participants answered a questionnaire about sociodemographic aspects and risk factors for infection. Anti-HTLV-1/2 antibodies were detected in two individuals (one man and one woman), for an overall seroprevalence of 0.65%. Both individuals belonged to the community of São José de Icatú. The search for intrafamilial infection identified two other infected women, which increased the general prevalence of HTLV-1 among the Icatú to 6.25% (4/64). Western blot and qPCR confirmed their HTLV-1 infection, and phylogenetic analysis demonstrated that the isolates were of the cosmopolitan subtype and transcontinental subgroup. Epidemiological investigation of the cases revealed that the three women, at some point in their lives, had a relationship with the infected male individual. HTLV-1 is transmitted silently between individuals in the community of São José de Icatú with a present or past family relationship, stressing the need for screening and laboratory diagnosis to prevent further dissemination of the virus and surveillance of disease emergence.
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Affiliation(s)
- Bruno José Sarmento Botelho
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
| | - Wandrey Roberto dos Santos Brito
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém 66075-110, Pará, Brazil
| | - Gabriel dos Santos Pereira Neto
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém 66075-110, Pará, Brazil
| | - Janete Silvana Souza Gonçalves
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém 66075-110, Pará, Brazil
| | - Bruna Maria Silva Oliveira
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
| | - Camille Marcela Camarinha de Oliveira
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
| | - Aline Cecy Rocha de Lima
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém 66075-110, Pará, Brazil
| | - Sandra Souza Lima
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
| | | | | | - João Farias Guerreiro
- Human and Medical Genetics Laboratory, Federal University of Pará, Belém 66075-110, Pará, Brazil;
| | - Ricardo Ishak
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
| | - Antonio Carlos Rosário Vallinoto
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém 66075-110, Pará, Brazil
| | - Izaura M. Vieira Cayres Vallinoto
- Laboratory of Virology, Federal University of Pará, Belém 66075-110, Pará, Brazil; (B.J.S.B.); (W.R.d.S.B.); (G.d.S.P.N.); (J.S.S.G.); (B.M.S.O.); (C.M.C.d.O.); (A.C.R.d.L.); (S.S.L.); (R.I.)
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Federal University of Pará, Belém 66075-110, Pará, Brazil
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Bittencourt AL, Farre L. Infective dermatitis associated with human T-cell lymphotropic virus type-1, an underdiagnosed disease. Int J Infect Dis 2024; 145:107058. [PMID: 38697604 DOI: 10.1016/j.ijid.2024.107058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/10/2024] [Accepted: 04/10/2024] [Indexed: 05/05/2024] Open
Abstract
Infective dermatitis associated with human T-cell lymphotropic virus type-1 (HTLV-1) (IDH) is a severe form of chronically infected eczema occurring in early childhood, although very rarely cases have been reported in adults. Most of the cases are from Jamaica and Brazil and occur in individuals with low socioeconomic status. IDH is always associated with refractory Staphylococcus aureus or beta-hemolytic Streptococcus infection of the skin and nasal vestibules. Patients with IDH may develop other even more severe HTLV-1-associated diseases, such as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) of early or late appearance and adult T-cell leukemia/lymphoma. In the context of the Brazilian experience, it has been observed that 54% of IDH patients exhibit the juvenile form of HAM/TSP while the estimated incidence of adult HAM/TSP is 3%. As there are no curative treatments for HTLV-1 infection (or vaccines) or most of its associated diseases, prevention of infection is fundamental, mainly by vertical transmission, as it is responsible for the development of IDH, infantojuvenile HAM/TSP, and ATL. Public measures to reduce this transmission must be implemented urgently. Furthermore, it is recommended, mainly in HTLV-1 endemic areas, to search for HTLV-1 infection in all patients with infected eczema, even in adults.
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Affiliation(s)
- A L Bittencourt
- Department of Pathology, Prof. Edgard Santos Teaching Hospital, Federal University of Bahia, Salvador, Brazil
| | - L Farre
- Program Against Cancer Therapeutic Resistance (ProCURE), Catalan Institute of Oncology (ICO), ONCOBELL, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet del Llobregat, Spain.
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Figueroa JP, Cooper CJ, Duncan JJ, Anzinger JJ. Urgent need to prevent mother-to-child transmission of HTLV-1 in Jamaica. LANCET REGIONAL HEALTH. AMERICAS 2024; 35:100778. [PMID: 38799183 PMCID: PMC11127268 DOI: 10.1016/j.lana.2024.100778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024]
Affiliation(s)
- J. Peter Figueroa
- Department of Community Health and Psychiatry, The University of the West Indies, Mona, Kingston 7, Jamaica
- Epidemiology Research and Training Unit, Kingston 5, Jamaica
| | | | - Jacqueline J. Duncan
- Department of Community Health and Psychiatry, The University of the West Indies, Mona, Kingston 7, Jamaica
- Epidemiology Research and Training Unit, Kingston 5, Jamaica
| | - Joshua J. Anzinger
- Department of Microbiology, The University of the West Indies, Mona, Kingston 7, Jamaica
- Global Virus Network, Baltimore, MD, USA
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Iordan I, Vlădăreanu AM, Mambet C, Onisâi M, Cîșleanu D, Bumbea H. Clinical Features and Survival Outcome in Aggressive-Type Adult T-Cell Leukemia/Lymphoma Patients: Real-Life Experience of a Single Center from an HTLV-1 Endemic Country. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:872. [PMID: 38929489 PMCID: PMC11205487 DOI: 10.3390/medicina60060872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/15/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: Adult T-cell leukemia/lymphoma (ATLL) is a highly aggressive T-cell lymphoproliferative disease associated with the human T-cell lymphotropic virus type I (HTLV-1). ATLL is a rare disease, found more frequently in HTLV-1-endemic areas, Romania being one of them. Despite treatment advances, the prognosis remains dismal. We aimed to describe the clinical, biological, and survival outcome features of Romanian patients with aggressive-type ATLL. Materials and Methods: We report the data of a prospective, observational, and unicentric study of all 20 patients diagnosed with lymphoma and acute types of ATLL at our center over the past 12 years. Data were collected from the patients' medical records. Results: Lymphoma-type ATLL (60%) was more common than acute-type ATLL (40%). Median age at diagnosis was 40.5 years, and most patients were female. Laboratory data revealed significant differences between acute and lymphoma-type ATLL, namely, higher leukocyte (p = 0.02) and lymphocyte counts (p = 0.02) and higher levels of corrected calcium (p = 0.001) in acute-type ATLL. All patients received chemotherapy, and only two underwent allogeneic stem cell transplantation. Only six patients obtained a complete or partial response to chemotherapy, mostly the lymphoma-type ones. The median survival for all patients was 6.37 months, with higher survival in the lymphoma-type ATLL (8.16 months) than in the acute-type (3.60 months). Normal calcium levels (p = 0.011), uric acid (p = 0.005), BUN score (p = 0.000), JCOG-PI moderate risk (p = 0.038), and obtaining complete or partial response (p = 0.037) were associated with higher survival. Conclusion: Aggressive-type ATLL among Romanian patients presents distinct characteristics, including younger age at diagnosis, female predominance, and higher incidence of lymphoma-type ATLL compared to currently reported data. Survival remains very low, with all subtypes experiencing a median survival of less than one year.
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Affiliation(s)
- Iuliana Iordan
- Department of Hematology, “Carol Davila” University of Medicine and Pharmacy, Emergency University Hospital of Bucharest, 050098 Bucharest, Romania; (I.I.)
- Department of Medical Semiology and Nephrology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Ana-Maria Vlădăreanu
- Department of Hematology, “Carol Davila” University of Medicine and Pharmacy, Emergency University Hospital of Bucharest, 050098 Bucharest, Romania; (I.I.)
| | - Cristina Mambet
- Department of Hematology, “Carol Davila” University of Medicine and Pharmacy, Emergency University Hospital of Bucharest, 050098 Bucharest, Romania; (I.I.)
- Department of Virology, “Stefan S. Nicolau” Institute, 030304 Bucharest, Romania
| | - Minodora Onisâi
- Department of Hematology, “Carol Davila” University of Medicine and Pharmacy, Emergency University Hospital of Bucharest, 050098 Bucharest, Romania; (I.I.)
| | - Diana Cîșleanu
- Department of Hematology, “Carol Davila” University of Medicine and Pharmacy, Emergency University Hospital of Bucharest, 050098 Bucharest, Romania; (I.I.)
| | - Horia Bumbea
- Department of Hematology, “Carol Davila” University of Medicine and Pharmacy, Emergency University Hospital of Bucharest, 050098 Bucharest, Romania; (I.I.)
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O'Donnell JS, Jaberolansar N, Chappell KJ. Human T-lymphotropic virus type 1 and antiretroviral therapy: practical considerations for pre-exposure and post-exposure prophylaxis, transmission prevention, and mitigation of severe disease. THE LANCET. MICROBE 2024; 5:e400-e408. [PMID: 38246188 DOI: 10.1016/s2666-5247(23)00359-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/17/2023] [Accepted: 10/24/2023] [Indexed: 01/23/2024]
Abstract
Human T-lymphotropic virus type 1 (HTLV-1) is a retrovirus associated with substantial risk of secondary (often life-threatening) disease for the estimated 10 million to 20 million people infected globally. Despite a clear need, no HTLV-1-specific vaccine or antiretroviral therapy has been developed to date. Instead, existing public and primary health-care interventions inadequately focus on infection prevention and management of secondary diseases. In this Personal View, we discuss the evidence that exists to support the sensitivity of HTLV-1 to antiretroviral therapies approved by the US Food and Drug Administration for the treatment of HIV-1, how this sensitivity is affected by clinically relevant virological and immunological features, and additional practical considerations for the use of antiretroviral therapies in the context of HTLV-1.
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Affiliation(s)
- Jake S O'Donnell
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD, Australia; The Australian Institute for Biotechnology and Nanotechnology, The University of Queensland, St Lucia, QLD, Australia.
| | - Noushin Jaberolansar
- The Australian Institute for Biotechnology and Nanotechnology, The University of Queensland, St Lucia, QLD, Australia
| | - Keith J Chappell
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD, Australia; The Australian Institute for Biotechnology and Nanotechnology, The University of Queensland, St Lucia, QLD, Australia; Australian Infectious Disease Research Centre, The University of Queensland, St Lucia, QLD, Australia
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Quina M, Ramos D, Silva C, Pádua E. Diversity of Human T-Lymphotropic Virus Type 1 Cosmopolitan Subtype (HTLV-1a) Circulating in Infected Residents in Portugal. AIDS Res Hum Retroviruses 2024; 40:171-180. [PMID: 37462999 DOI: 10.1089/aid.2023.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023] Open
Abstract
Human T-cell lymphotropic virus type 1 (HTLV-1) prevalence in Portugal is low and mainly affects immigrants from endemic areas where human immunodeficiency virus (HIV) infection represents a public health problem. Despite the majority of HTLV-1-infected individuals remains asymptomatic, severe pathologies may develop after prolonged viral persistence, namely an aggressive form of leukemia. An increased mortality rate and faster progression to death is often related to HTLV-1/HIV coinfection. Nevertheless, studies showed that some antiretrovirals used in HIV treatment lead to a positive immune response against HTLV-1. This study aimed to analyze epidemiological and clinical data, and to assess the diversity of HTLV-1 strains circulating in infected residents diagnosed in the Portuguese national reference laboratory between 2010 and 2021. Long terminal repeat and env proviral sequences derived from 20 individuals were used to generate phylogenetic trees along with multiples reference sequences from different geographic origins retrieved from the database. Three samples belong to Portuguese natives and 17 belong to immigrants: 15 from several countries of Africa, 1 from South America, and 1 from Europe; 6 patients (30%, mean age 40.3 years) showed HTLV-1-related diseases, and 6 (30%, mean age 45.2 years) were coinfected with HIV/AIDS. The results show that the Cosmopolitan subtype is circulating in Portugal, with 10 sequences being classified as subgroup A, that include Portuguese and natives from S. Tomé and Príncipe with a mean age of 39.4 years, and 10 sequences that segregated into the Senegal cluster derived from natives born in Guinea-Bissau with a mean age of 43.5 years. A high proportion of HTLV-1-related diseases and HIV/AIDS coinfection was observed. Risk behavior practices and the absence of specific control measures, including diagnostic and treatment, may contribute to a silent dissemination of a broad diversity of HTLV-1 strains and, therefore, the increased rate of progression to debilitating diseases. In this manner, an early diagnostic and a molecular surveillance of HTLV-1 transmission remains necessary in Portugal.
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Affiliation(s)
- Miriam Quina
- Reference Laboratory of HIV and Hepatitis B and C, Infectious Diseases Department, National Institute of Health, Lisbon, Portugal
| | - Diogo Ramos
- Reference Laboratory of HIV and Hepatitis B and C, Infectious Diseases Department, National Institute of Health, Lisbon, Portugal
| | - Carolina Silva
- Reference Laboratory of HIV and Hepatitis B and C, Infectious Diseases Department, National Institute of Health, Lisbon, Portugal
| | - Elizabeth Pádua
- Reference Laboratory of HIV and Hepatitis B and C, Infectious Diseases Department, National Institute of Health, Lisbon, Portugal
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Prates G, Paiva A, Haziot ME, Fonseca LAM, Smid J, Marcusso RMDN, Assone T, de Oliveira ACP, Casseb J. Could Cesarean Delivery Help Prevent Mother-to-Child Transmission of Human T-Lymphotropic Virus Type 1? J Infect Dis 2023; 228:1766-1775. [PMID: 37386934 DOI: 10.1093/infdis/jiad219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 06/09/2023] [Accepted: 06/22/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Mother-to-child transmission (MTCT) of human T-lymphotropic virus type 1 (HTLV-1) is an important route of transmission that can cause lifelong infection. There is high morbidity and mortality due to adult T-cell leukemia/lymphoma, HTLV-1-associated myelopathy (HAM), and other inflammatory disorders. These conditions develop in nearly 10% of people with HTLV-1 infection, with a higher risk if infection occurs early in life. Identification of risk factors can inform targeted measures to reduce HTLV-1 MTCT. This study aimed to investigate the potential of cesarean delivery to prevent HTLV-1 MTCT. METHODS We performed a review of the cases of women and their offspring under regular follow-up at the HTLV-1 outpatient clinic at the Institute of Infectious Diseases Emilio Ribas. RESULTS A total of 177 HTLV-1-infected women and 369 adult offspring were investigated. Overall, 15% of the children were positive for HTLV-1 and 85% were negative. Regarding vertical transmission, we found that a breastfeeding duration of >6 months was associated with MTCT. Moreover, maternal proviral load was not associated with transmission, but high educational level and cesarean delivery were identified as protective factors. CONCLUSIONS HTLV-1 MTCT was associated with mother's age at delivery of >25 years, low educational level, prolonged breastfeeding, and vaginal delivery.
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Affiliation(s)
- Gabriela Prates
- Departamento de Dermatologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Arthur Paiva
- Departamento de Dermatologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
- Universitary Hospital of the Federal University of Alagoas, Maceió, Brazil
| | - Michel E Haziot
- Institute of Infectious Diseases "Emilio Ribas" (IIER) of Sao Paulo, Sao Paulo, Brazil
| | - Luiz Augusto M Fonseca
- Departamento de Dermatologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Jerusa Smid
- Institute of Infectious Diseases "Emilio Ribas" (IIER) of Sao Paulo, Sao Paulo, Brazil
| | | | - Tatiane Assone
- Departamento de Dermatologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
- Departamento de Medicina Legal, Bioética, Medicina do Trabalho e Medicina Física e Reabilitação, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Jorge Casseb
- Departamento de Dermatologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
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Uchimaru K, Itabashi K. Measures for the Prevention of Mother-to-Child Human T-Cell Leukemia Virus Type 1 Transmission in Japan: The Burdens of HTLV-1-Infected Mothers. Viruses 2023; 15:2002. [PMID: 37896779 PMCID: PMC10610977 DOI: 10.3390/v15102002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023] Open
Abstract
The main mode of mother-to-child transmission of the human T-cell leukemia virus (HTLV)-1 is through breastfeeding. Although the most reliable nutritional regimen to prevent HTLV-1 transmission is exclusive formula feeding, a recent meta-analysis revealed that short-term breastfeeding within 90 days does not increase the risk of infection. The protocol of the Japanese Health, Labor, and Welfare Science Research Group primarily recommended exclusive formula feeding for mothers who are positive for HTLV-1. However, there has been no quantitative research on the difficulties experienced by HTLV-1-positive mothers in carrying out these nutritional regimens, including the psychological burden. Therefore, this review was performed to clarify the burdens and difficulties encountered by mothers who are positive for HTLV-1; to this end, we analyzed the data registrants on the HTLV-1 career registration website "Carri-net" website. The data strongly suggest that it is not sufficient to simply recommend exclusive formula feeding or short-term breastfeeding as a means of preventing mother-to-child transmission; it is important for health care providers to understand that these nutritional regimens represent a major burden for pregnant women who are positive for HTLV-1 and to provide close support to ensure these women's health.
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Affiliation(s)
- Kaoru Uchimaru
- Department of Tumor Cell Biology, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo 1088639, Japan
| | - Kazuo Itabashi
- Aiseikai-Memorial Ibaraki Welfare and Medical Center, Ibaraki 3100836, Japan;
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Nunes da Silva A, Araújo THA, Boa-Sorte N, Farias G, Galvão-Barroso AK, de Carvalho A, Vicente AC, Galvão-Castro B, Rios Grassi MF. Epidemiological and molecular evidence of intrafamilial transmission through sexual and vertical routes in Bahia, the state with the highest prevalence of HTLV-1 in Brazil. PLoS Negl Trop Dis 2023; 17:e0011005. [PMID: 37769013 PMCID: PMC10593241 DOI: 10.1371/journal.pntd.0011005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 10/23/2023] [Accepted: 09/19/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION Familial clustering of HTLV-1 and related diseases has been reported in Brazil. However, intrafamilial transmission of HTLV-1 based on molecular analysis has been studied only in a few communities of Japanese immigrants and African-Brazilians. OBJECTIVE To investigate the familial clustering of HTLV-1 infection and to determine the likely routes of transmission through epidemiological and genetic analyzes. METHODS Medical records of 1,759 HTLV-1+ patients from de the Center for HTLV in Salvador, Brazil, were evaluated to identify first-degree relatives previously tested for HTLV-1. Familial clustering was assumed if more than one member of the same family was HTLV-1+. LTR regions of HTLV-1 sequences were analyzed for the presence of intrafamilial polymorphisms. Family pedigrees were constructed and analyzed to infer the likely transmission routes of HTLV-1. RESULTS In 154 patients at least one other family member had tested positive for HTLV-1 (a total of 182 first-degree relatives). Of the 91 couples (182 individuals), 51.6% were breastfed, and 67.4% reported never using a condom. Of the 42 mother-child pairs, 23.8% had a child aged 13 years or younger; all mothers reported breastfeeding their babies. Pedigrees of families with 4 or more members suggests that vertical transmission is a likely mode of transmission in three families. Three families may have had both vertical and sexual transmission routes for HTLV-1. The genetic signatures of the LTR region of 8 families revealed 3 families with evidence of vertical transmission, another 3 families (spouses) with sexual transmission, and one family with both transmission routes. HTLV-1 sequences belonged to Cosmopolitan subtype HTLV-1a Transcontinental subgroup A. CONCLUSION Sexual and vertical transmission routes contribute to the intrafamilial spread of HTLV-1 in the state of Bahia.
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Affiliation(s)
| | | | - Ney Boa-Sorte
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brasil
| | - Giovanne Farias
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brasil
| | | | | | | | - Bernardo Galvão-Castro
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brasil
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brasil
| | - Maria Fernanda Rios Grassi
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brasil
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brasil
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Materniak-Kornas M, Kubiś P, Sell B, Pougialis G, Löchelt M, Kuźmak J. An Outbred Calf Model for Determining Innate Immune Sensing and Evolutionary Trajectories of a Cell Culture-Adapted Bovine Foamy Virus Variant. Viruses 2023; 15:1772. [PMID: 37632114 PMCID: PMC10458543 DOI: 10.3390/v15081772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/10/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Bovine foamy virus (BFVbta) displays a very high degree of cell-associated replication which is unprecedented even among the other known foamy viruses. Interestingly, recent studies have shown that it can in fact adapt in vitro to high-titer (HT) cell-free transmission due to genetic changes acquired during repeated rounds of cell-free BFVbta passages in immortalized bovine MDBK cells. Molecular clones obtained from the HT BFVbta Riems cell-free variant (HT BFVbta Riems) have been thoroughly characterized in MDBK cell cultures However, during recent years, it has become increasingly clear that the source of the host cells used for virus growth and functional studies of virus replication and virus-cell interactions plays a paramount role. Established cell lines, mostly derived from tumors, but occasionally experimentally immortalized and transformed, frequently display aberrant features relating, for example. to growth, metabolism, and genetics. Even state-of-the-art organoid cultures of primary cells cannot replicate the conditions in an authentic host, especially those concerning cell diversity and the role of innate and adaptive immunity. Therefore, to determine the overall replication characteristics of the cloned wt and HT BFVbta Riems variant, we conducted a small-scale animal pilot study. The replication of the original wt BFVbta Riems isolate, as well as that of its HT variant, were analyzed. Both BFVbta variants established infection in calves, with proviruses in peripheral blood mononuclear cells and induced Gag-specific antibodies. In addition, a related pattern in the host innate immune reaction was detected in the peripheral blood leukocytes of the BFV-infected calves. Surprisingly, an analysis of the Gag sequence two weeks post-inoculation revealed that the HT BFVbta variant showed a very high level of genetic reversion to the wild type (parental BFVbta genotype).
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Affiliation(s)
- Magdalena Materniak-Kornas
- Department of Biochemistry, National Veterinary Research Institute, 24-100 Pulawy, Poland; (P.K.); (J.K.)
| | - Piotr Kubiś
- Department of Biochemistry, National Veterinary Research Institute, 24-100 Pulawy, Poland; (P.K.); (J.K.)
| | - Bartosz Sell
- Department of Pharmacology and Toxicology, National Veterinary Research Institute, 24-100 Pulawy, Poland;
| | - Georgios Pougialis
- Division of Viral Transformation Mechanisms, Research Program Infection, Inflammation and Cancer, German Cancer Research Center, 69120 Heidelberg, Germany; (G.P.); (M.L.)
| | - Martin Löchelt
- Division of Viral Transformation Mechanisms, Research Program Infection, Inflammation and Cancer, German Cancer Research Center, 69120 Heidelberg, Germany; (G.P.); (M.L.)
- Division of Virus-Associated Carcinogenesis, Research Program Infection, Inflammation and Cancer, German Cancer Research Center, 69120 Heidelberg, Germany
| | - Jacek Kuźmak
- Department of Biochemistry, National Veterinary Research Institute, 24-100 Pulawy, Poland; (P.K.); (J.K.)
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O'Donnell JS, Hunt SK, Chappell KJ. Integrated molecular and immunological features of human T-lymphotropic virus type 1 infection and disease progression to adult T-cell leukaemia or lymphoma. Lancet Haematol 2023; 10:e539-e548. [PMID: 37407143 DOI: 10.1016/s2352-3026(23)00087-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 07/07/2023]
Abstract
The human T-lymphotropic virus type 1 (HTLV-1) retrovirus infects 10-20 million people globally, with endemic regions in southwestern Japan, the Caribbean basin, Africa, and central Australia. HTLV-1 is associated with lifelong infection and immune suppression, resulting in a range of serious sequalae, including adult T-cell leukaemia or lymphoma (ATLL) in 5% of cases. To date, there are no preventive or curative treatments for HTLV-1 and treatment outcomes for ATLL remain generally poor. Depending on the disease subtype, overall survival is 8-55 months. Recent advancements in the past decade have identified genetic, molecular, and immunological events occurring throughout the lives of individuals infected with HTLV-1 and of those who progress to ATLL. In addition, updated guidelines for clinical management have been published. With the aim of focusing research efforts on the development of treatments for both HTLV-1 infections and ATLL, we have conceptualised a four-step disease model for HTLV-1-associated ATLL: (1) viral exposure, (2) establishment of chronic infection, (3) cellular transformation and evolution, and (4) disease presentation and management. For each stage we describe the clinical features, molecular and immunological factors involved, potential biomarkers of disease progression, and the therapeutic applicability of individual targets. We also discuss emerging concepts and novel treatment approaches. Our hope is that this model will promote research interest and guide the testing of new treatments for this neglected virus and its associated rare cancer.
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Affiliation(s)
- Jake S O'Donnell
- School of Chemistry and Molecular Biosciences, and the Australian Institute for Biotechnology and Nanotechnology, The University of Queensland, St Lucia, QLD, Australia.
| | - Stewart K Hunt
- Department of Haematology and Bone Marrow Transplant, Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Keith J Chappell
- School of Chemistry and Molecular Biosciences, and the Australian Institute for Biotechnology and Nanotechnology, The University of Queensland, St Lucia, QLD, Australia; Australian Infectious Disease Research Centre, The University of Queensland, St Lucia, QLD, Australia
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Itabashi K, Miyazawa T, Uchimaru K. How Can We Prevent Mother-to-Child Transmission of HTLV-1? Int J Mol Sci 2023; 24:ijms24086961. [PMID: 37108125 PMCID: PMC10138424 DOI: 10.3390/ijms24086961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
The perception of human T-cell leukemia virus type 1 (HTlV-1) infection as a "silent disease" has recently given way to concern that its presence may be having a variety of effects. HTLV-1 is known to cause adult T-cell leukemia (ATL), an aggressive cancer of peripheral CD4 T cells; however, it is also responsible for HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Most patients develop ATL as a result of HTLV-1 mother-to-child transmission. The primary route of mother-to-child transmission is through the mother's milk. In the absence of effective drug therapy, total artificial nutrition such as exclusive formula feeding is a reliable means of preventing mother-to-child transmission after birth, except for a small percentage of prenatal infections. A recent study found that the rate of mother-to-child transmission with short-term breastfeeding (within 90 days) did not exceed that of total artificial nutrition. Because these preventive measures are in exchange for the benefits of breastfeeding, clinical applications of antiretroviral drugs and immunotherapy with vaccines and neutralizing antibodies are urgently needed.
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Affiliation(s)
- Kazuo Itabashi
- Aiseikai-Memorial Ibaraki Welfare and Medical Center, Ibaraki 3100836, Japan
| | - Tokuo Miyazawa
- Department of Pediatrics, Showa University School of Medicine, Tokyo 1428666, Japan
| | - Kaoru Uchimaru
- Department of Hematology/Oncology, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo 1088639, Japan
- Laboratory of Tumor Cell Biology, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo 1088639, Japan
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Owatari S, Tokunaga M, Nakamura D, Uozumi K, Sagara Y, Nakamura H, Haraguchi K, Nakano N, Yoshimitsu M, Ito Y, Utsunomiya A, Otsuka M, Hanada S, Iwanaga M, Ishitsuka K. A decrease in newly diagnosed patients with adult T-cell leukemia/lymphoma in Kagoshima, a highly endemic area of HTLV-1 in southwestern Japan. Leuk Lymphoma 2023; 64:865-873. [PMID: 36772789 DOI: 10.1080/10428194.2023.2173524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Adult T-cell leukemia/lymphoma (ATL) is a peripheral T-cell malignancy caused by human T-cell leukemia virus type-I (HTLV-1). This study investigated whether the number of newly diagnosed patients with ATL is decreasing in the background of a declining number of individuals infected by HTLV-1 in Kagoshima, Japan, one of the most endemic areas of HTLV-1 in the world. We retrospectively analyzed the number of newly diagnosed patients with ATL between January 2001 and December 2021 in three major hospitals. The number of newly diagnosed patients with B-cell non-Hodgkin lymphoma (B-NHL) in the same period was examined as an internal control. One thousand eighteen and 2,029 patients with ATL and B-NHL were registered, respectively. The age-adjusted incidence of ATL steadily increased between 2001 and 2012, whereas that between 2013 and 2021 decreased. Despite the limitation of its retrospective nature, this is the first report indicating a decrease in ATL patients in Japan.
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Affiliation(s)
- Satsuki Owatari
- Department of Hematology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Masahito Tokunaga
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Daisuke Nakamura
- Department of Hematology and Rheumatology, Kagoshima University, Kagoshima, Japan
| | - Kimiharu Uozumi
- Department of Medical Oncology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Yasuko Sagara
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Fukuoka, Japan
| | - Hitomi Nakamura
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Fukuoka, Japan
| | - Koichi Haraguchi
- Department of Hematology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Nobuaki Nakano
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Makoto Yoshimitsu
- Department of Hematology and Rheumatology, Kagoshima University, Kagoshima, Japan
| | - Yoshikiyo Ito
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Atae Utsunomiya
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Maki Otsuka
- Department of Hematology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Shuichi Hanada
- Department of Hematology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Masako Iwanaga
- Department of Medical Technology, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Kenji Ishitsuka
- Department of Hematology and Rheumatology, Kagoshima University, Kagoshima, Japan
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Kowada A. Cost-effectiveness of human T-cell leukemia virus type 1 (HTLV-1) antenatal screening for prevention of mother-to-child transmission. PLoS Negl Trop Dis 2023; 17:e0011129. [PMID: 36809372 PMCID: PMC9983854 DOI: 10.1371/journal.pntd.0011129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 03/03/2023] [Accepted: 01/31/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Human T-cell leukemia virus type 1 (HTLV-1) causes adult T-cell leukemia-lymphoma (ATL) and HTLV-1-associated myelopathy-tropical spastic paraparesis (HAM/TSP) with a poor prognosis. This study aimed to evaluate the cost-effectiveness and health impact of HTLV-1 antenatal screening. METHODOLOGY/PRINCIPAL FINDINGS A state-transition model was developed for HTLV-1 antenatal screening and no screening over a lifetime horizon from a healthcare payer perspective. A hypothetical cohort of 30-year-old individuals was targeted. The main outcomes were costs, quality-adjusted life-years (QALYs), life expectancy life-years (LYs), incremental cost-effectiveness ratios (ICERs), HTLV-1 carriers, ATL cases, HAM/TSP cases, ATL-associated deaths, and HAM/TSP-associated deaths. The willingness-to-pay (WTP) threshold was set at US$50,000 per QALY gained. In the base-case analysis, HTLV-1 antenatal screening (US$76.85, 24.94766 QALYs, 24.94813 LYs, ICER; US$40,100 per QALY gained) was cost-effective compared with no screening (US$2.18, 24.94580 QALYs, 24.94807 LYs). Cost-effectiveness was sensitive to the maternal HTLV-1 seropositivity rate, HTLV-1 transmission rate with long-term breastfeeding from HTLV-1 seropositive mothers to children, and the cost of the HTLV-1 antibody test. HTLV-1 antenatal screening was cost-effective when the maternal HTLV-1 seropositivity rate was greater than 0.0022 and the cost of the HTLV-1 antibody test was lower than US$94.8. Probabilistic sensitivity analysis using a second-order Monte-Carlo simulation showed that HTLV-1 antenatal screening was 81.1% cost-effective at a WTP threshold of US$50,000 per QALY gained. For 10,517,942 individuals born between 2011 and 2021, HTLV-1 antenatal screening costs US$785 million, increases19,586 QALYs and 631 LYs, and prevents 125,421 HTLV-1 carriers, 4,405 ATL cases, 3,035 ATL-associated deaths, 67 HAM/TSP cases, and 60 HAM/TSP-associated deaths, compared with no screening over a lifetime. CONCLUSION/SIGNIFICANCE HTLV-1 antenatal screening is cost-effective and has the potential to reduce ATL and HAM/TSP morbidity and mortality in Japan. The findings strongly support the recommendation for HTLV-1 antenatal screening as a national infection control policy in HTLV-1 high-prevalence countries.
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Affiliation(s)
- Akiko Kowada
- Department of Occupational Health, Kitasato University Graduate School of Medical Sciences, Sagamihara, Kanagawa, Japan
- * E-mail: ,
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High Expression of Inflammatory Cytokines and Chemokines in Human T-lymphotropic Virus 1-Associated Adult T-cell Leukemia/Lymphoma. Jundishapur J Microbiol 2022. [DOI: 10.5812/jjm-132348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Human T-cell lymphotropic virus type 1 (HTLV-1) is the etiological agent of adult T-cell leukemia/lymphoma (ATLL) without any specific antiviral. Objectives: This study aimed to evaluate the expression level of inflammatory chemokines and pro-inflammatory cytokines in ATLL patients, asymptomatic carriers (ACs), and healthy individuals to assess the role of these inflammatory markers in ATLL pathogenicity. Methods: This study was conducted from May 2021 to August 2022. The ATLL blood samples were collected from the oncology wards of Imam Khomeini, Shariati, and Imam Hossein hospitals, in Tehran, Iran. The blood samples of ACs and normal control subjects were collected from blood donors referred to blood transfusion centers of Tehran and Alborz provinces, Iran. RNA extraction, complementary DNA (cDNA) synthesis, and real-time polymerase chain reaction (PCR) were done in targeted sample groups to investigate the correlation and expression rate of C-C motif chemokine ligand 3 (CCL3), C-C motif chemokine ligand 4 (CCL4), C-X-C motif chemokine ligand 8 (CXCL8), interleukin 23 subunit alpha (IL-23A), and interleukin 17 A (IL-17A). Results: A total of 30 samples were collected from 3 groups. The CCL3, CCL4, CXCL8, and IL-17A messenger RNA (mRNA) expression levels were significantly upregulated in the ATLL groups. There was a significant difference between CCL3 expression between the ACs and ATLL groups. In addition, CCL4 and CXCL8 expression levels were more significant in the ATLL group than in the normal control group. The IL-17A expression level significantly increased between groups. The IL-23A expression levels had no significant differences between the ATLL, ACs, and normal control groups. Conclusions: This study showed significant upregulation of pro-inflammatory cytokines and chemokines mRNAs in HTLV-1–associated ATLL compared to the ACs and normal control groups. Conducting more experiments to investigate the therapeutic effect of chemokines/cytokines in ATLL is essential.
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Komatsu N, Iwanaga M, Hasegawa Y, Miura S, Fuchi N, Moriuchi H, Yanagihara K, Miura K. Frequency of HTLV-1 seroconversion between pregnancies in Nagasaki, Japan, 2011–2018. Front Microbiol 2022; 13:1036955. [DOI: 10.3389/fmicb.2022.1036955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022] Open
Abstract
BackgroundHuman T-cell leukemia virus type-1 (HTLV-1) is transmitted vertically from an infected mother to her child via breastfeeding during infancy or horizontally via sexual contact. However, little information is available on the HTLV-1 seroconversion rate in pregnant mothers and the impact of new HTLV-1 infection on mothers and babies during the perinatal period.MethodsFrom the database of a prefecture-wide antenatal adult T-cell leukemia prevention program in Nagasaki, Japan, we extracted data on 57,323 pregnant women who were screened for anti-HTLV-1 antibody during 2011–2018. Data on the 16,863 subjects whose HTLV-1 proviral load (PVL) was measured more than twice were included in our analyses.ResultsIn total, 133 (0.79%) pregnant women were HTLV-1-positive during their first pregnancy and nine (0.05%) seroconverted before or during subsequent pregnancies (between pregnancies). The median PVL (per 100 peripheral blood mononuclear cells) was significantly lower in the seroconverted mothers (0.10%) than in the initially seropositive mothers (0.15%). A repeated measures correlation analysis for the individual PVLs of the HTLV-1-positive pregnant women showed that PVL increased with parity number (rrm = 0.25) with no perinatal problems.ConclusionThe HTLV-1 seroconversion rate between pregnancies was 0.05%, and their HTLV-1 PVL increased annually but no perinatal problems were noted.
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Current Interventions to Prevent HTLV-1 Mother-to-Child Transmission and Their Effectiveness: A Systematic Review and Meta-Analysis. Microorganisms 2022; 10:microorganisms10112227. [PMID: 36363819 PMCID: PMC9694434 DOI: 10.3390/microorganisms10112227] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/12/2022] Open
Abstract
Human T lymphotropic virus 1 (HTLV-1) may be transmitted from mother to child and affects at least 5−10 million individuals worldwide, with severe consequences on health. Strategies to prevent transmission are important, as there is no treatment or vaccine. This systematic review aimed to identify interventions to prevent HTLV-1 mother-to-child transmission and to determine their effectiveness. Exclusive formula feeding, short-term breastfeeding, use of freeze−thaw milk, milk pasteurization, maternal and infant antiretroviral drugs, caesarean section, early clamping of umbilical cord, screening of milk donors and avoidance of cross-breastfeeding were identified as possible strategies. Avoidance of breastfeeding is an intervention that prevents 85% of transmissions. This strategy is recommended in Japan, Brazil, Colombia, Canada, Chile, Uruguay, the USA and some regions of French Guyana. Whilst breastfeeding for <3 months does not increase the risk of transmission compared to exclusive formula-feeding, concerns remain regarding the limited number of studies outside Japan, and the lack of information on women having higher risk of HTLV-1 transmission and on the ability of women to discontinue breastfeeding. Additional interventions are plausible, but data on their effectiveness are limited. The acceptance of interventions is high. These findings may guide healthcare professionals and support policymakers in implementing policies to avoid HTLV-1 mother-to-child transmission.
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Establishment of a Cynomolgus Macaque Model of Human T-Cell Leukemia Virus Type 1 (HTLV-1) Infection by Direct Inoculation of Adult T-Cell Leukemia Patient-Derived Cell Lines for HTLV-1 Infection. J Virol 2022; 96:e0133922. [DOI: 10.1128/jvi.01339-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
HTLV-1 was discovered in the 1980s as the causative agent of adult T-cell leukemia and HTLV-1-associated myelopathy/tropical spastic paraparesis. However, the precise mechanisms leading to HTLV-1 chronic infection and the onset of the diseases still remain unidentified.
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Mouinga-Ondémé A, Boundenga L, Koumba Koumba IP, Idam Mamimandjiami A, Diané A, Engone-Ondo JD, Djuicy DD, Sica J, Mombo LE, Gessain A, Aghokeng Fobang A. Human T-Lymphotropic virus type 1 and human immunodeficiency virus co-infection in rural Gabon. PLoS One 2022; 17:e0271320. [PMID: 35867643 PMCID: PMC9307203 DOI: 10.1371/journal.pone.0271320] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 06/28/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Human T-cell lymphotrophic virus type-1 (HTLV-1) and human immunodeficiency virus (HIV-1) co-infection occur in many populations. People living with HIV-1 and infected with HTLV-1 seem more likely to progress rapidly towards AIDS. Both HTLV-1 and HIV-1 are endemic in Gabon (Central Africa). We investigated HTLV-1 and HIV-1 co-infection in the Haut-Ogooué province, and assessed factors that may favor the rapid evolution and progression to AIDS in co-infected patients. Methods Plasma samples from HTLV-1 patients were tested using ELISA, and positive samples were then tested by western blot assay (WB). We used the polymerase chain reaction to detect HTLV-1 Tax/Rex genes using DNA extracted from the buffy coat of ELISA-positives samples. Results We recruited 299 individuals (mean age 46 years) including 90 (30%) men and 209 (70%) women, all of whom are under treatment at the Ambulatory Treatment Centre of the province. Of these, 45 were ELISA HTLV-1/2 seropositive. According to WB criteria, 21 of 45 were confirmed positive: 20 were HTLV-1 (44%), 1 was HTLV-1/2 (2%), 2 were indeterminate (4%) and 22 were seronegative (49%). PCR results showed that 23 individuals were positive for the Tax/Rex region. Considering both serological and molecular assays, the prevalence of HTLV-1 infection was estimated at 7.7%. Being a woman and increasing age were found to be independent risk factors for co-infection. Mean CD4+ cell counts were higher in HTLV-1/HIV-1 co-infected (578.1 (± 340.8) cells/mm3) than in HIV-1 mono-infected (481.0 (± 299.0) cells/mm3) Individuals. Similarly, the mean HIV-1 viral load was Log 3.0 (± 1.6) copies/ml in mono-infected and Log 2.3 (± 0.7) copies/ml in coinfected individuals. Conclusion We described an overall high prevalence of HTLV-1/HIV-1 co-infection in Gabon. Our findings stress the need of strategies to prevent and manage these co-infections.
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Affiliation(s)
- Augustin Mouinga-Ondémé
- Unité des Infections Rétrovirales et Pathologies Associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- * E-mail:
| | - Larson Boundenga
- Groupe Evolution et Transmission Inter-espèces des Pathogènes (GETIP), Département de Parasitologie, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Department of Anthropology, Durham University, Durham, United Kingdom
| | - Ingrid Précilya Koumba Koumba
- Unité des Infections Rétrovirales et Pathologies Associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Antony Idam Mamimandjiami
- Unité des Infections Rétrovirales et Pathologies Associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Abdoulaye Diané
- Unité des Infections Rétrovirales et Pathologies Associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Jéordy Dimitri Engone-Ondo
- Unité des Infections Rétrovirales et Pathologies Associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Delia Doreen Djuicy
- Unité des Infections Rétrovirales et Pathologies Associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Jeanne Sica
- Centre de Traitement Ambulatoire, Franceville, Gabon
| | - Landry Erik Mombo
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
| | - Antoine Gessain
- Unité d’Epidémiologie et de Physiopathologie des Virus Oncogènes (EPVO), et CNRS UMR3569, Institut Pasteur de Paris, Paris, France
| | - Avelin Aghokeng Fobang
- Unité Mixte de Recherche sur le VIH et les Maladies Infectieuses Associées, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- MIVEGEC, Université de Montpellier, CNRS, IRD – Montpellier, Montpellier, France
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Simioli FR, Bouzas MB, Mijalovsky D, Pineda MV, Mammana L, Mangano A, Orduna TA. Making Visible HTLV Infection in a Non-endemic Area of Argentina. Front Med (Lausanne) 2022; 9:892159. [PMID: 35879924 PMCID: PMC9307993 DOI: 10.3389/fmed.2022.892159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/27/2022] [Indexed: 11/13/2022] Open
Abstract
In Argentina, the human T-cell lymphotropic virus type 1 (HTLV-1) infection has been documented mainly among blood banks with a prevalence of ~0.02–0.046% for Buenos Aires city, 0.8% for the northeast, and 1% for the northwest; both areas are considered endemic for HTLV-2 and 1, respectively. Policies and specific guidelines for testing blood donors for HTLV are included since 2005. Screening for antibodies is performed at blood banks and confirmatory testing is performed at reference laboratories. There are no specific recommendations for the assistance of communities and individuals affected, nor referral to specialized clinics on the HTLV infection. In 2016, as a strategy of intervention, we opened a specialized clinical attendance in a referral infectious diseases public hospital for the comprehensive approach to patients with HTLV, offering follow-up and counseling for patients and their families for the early diagnosis of HTLV-1/2 and related diseases. During the study, 124 patients with presumptive HTLV positive diagnosis from blood bank, symptomatic patients (SPs), relatives, and descendants visited the unit. A total of 46 patients were HTLV positive (38 HTLV-1 and 8 HTLV-2). There were nine SPs (2 adult T-cell leukemia/lymphoma [ATL] and 7 HTLV-1-associated myelopathy/tropical spastic paraparesis [HAM/TSP]). All patients with HTLV-1 and−2 were offered to study their relatives. Two out of 37 (5.4%) descendants tested were positive for HTLV-1. Sexual partners were studied; among 6 out of 11 couples (54.5%) were found positive (5 HTLV-1 and 1 HTLV-2). Other relatives, such as mothers (1/2) and siblings (1/6), were positive for HTLV-1. According to the place of birth among HTLV-1 carriers, 58% were born in an endemic area or in countries where HTLV infection is considered endemic while for HTLV-2 carriers, 12.5% were born in an endemic area of Argentina. The proviral load (pVL) was measured in all, patients with HTLV-1 being higher in symptomatic compared with asymptomatic carriers. In addition, two pregnant women were early diagnosed during their puerperium and breastmilk replacement by formula was indicated. Inhibition of lactation was also indicated. Our study provides tools for a multidisciplinary approach to the infection and reinforces the importance of having specialized clinical units in neglected diseases, such as HTLV for counseling, clinical and laboratory follow-up, and providing useful information for patients for self-care and that of their families.
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Affiliation(s)
- Federico R. Simioli
- Centro Municipal de Patología Regional Argentina y Medicina Tropical (CEMPRA-MT), Hospital de Infecciosas F.J. Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
| | - Maria B. Bouzas
- Division Análisis Clínicos, Hospital de Infecciosas F.J. Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
- *Correspondence: Maria B. Bouzas
| | - Dana Mijalovsky
- Centro Municipal de Patología Regional Argentina y Medicina Tropical (CEMPRA-MT), Hospital de Infecciosas F.J. Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
| | - Maria V. Pineda
- Unidad de Virología y Epidemiología Molecular-CONICET- Hospital de Pediatría “Prof. Dr. Juan P. Garrahan, ” Ciudad Autónoma de Buenos Aires, Argentina
| | - Lilia Mammana
- Unidad de Virología, División Análisis Clínicos, Hospital de Infecciosas F.J. Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
| | - Andrea Mangano
- Unidad de Virología y Epidemiología Molecular-CONICET- Hospital de Pediatría “Prof. Dr. Juan P. Garrahan, ” Ciudad Autónoma de Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Argentina
- Andrea Mangano
| | - Tomas A. Orduna
- Centro Municipal de Patología Regional Argentina y Medicina Tropical (CEMPRA-MT), Hospital de Infecciosas F.J. Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
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Fowler F, Einsiedel L. A Qualitative Study Exploring Perceptions to the Human T Cell Leukaemia Virus Type 1 in Central Australia: Barriers to Preventing Transmission in a Remote Aboriginal Population. Front Med (Lausanne) 2022; 9:845594. [PMID: 35572972 PMCID: PMC9100826 DOI: 10.3389/fmed.2022.845594] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/28/2022] [Indexed: 01/24/2023] Open
Abstract
Background Central Australia has the highest recorded prevalence of infection with the human T cell leukaemia virus type 1 (HTLV-1) worldwide. Each of the clinical diseases associated with HTLV-1 have been reported in this region, including deaths due to adult T cell leukaemia, which is causally linked to HTLV-1. Nevertheless, no public health response has been implemented to reduce HTLV-1 transmission among the affected Aboriginal population. In the first study to explore the perceptions of healthcare professionals along with those of Aboriginal people whose communities are actually impacted by HTLV-1, we sought to understand the barriers to preventing HTLV-1 transmission in this remote area. Methodology/Principal Findings Semi and un-structured interviews were conducted with 30 Australian Aboriginal people, 26 non-Aboriginal healthcare professionals and 3 non-Aboriginal community workers. The purpose of the interviews was to explore perceptions towards HTLV-1 in a health context with a focus on sexual and reproductive rights. Deductive and inductive analyses were applied to the data and a decolonizing lens brought peripheral stories to the fore. A major finding was the contrast between views expressed by Aboriginal participants and healthcare professionals regarding the provision of knowledge to those affected. Aboriginal participants consistently articulated that they and their communities should be informed of, and can hold, knowledges pertaining to HTLV-1. This finding controverted the perceptions of healthcare professionals that the complexities of the virus would not be well-understood by their Aboriginal patients and that sharing HTLV-1 knowledges might overwhelm Aboriginal people. Further analyses revealed a spectrum of understanding and clinical practice, while also delineating signs of an imagined public health response. Conclusions/Significance HTLV-1 remains a neglected infection in Australia. Knowledge of HTLV-1 is held by a privileged medical elite and does not flow to marginalised Aboriginal people living in affected communities. We demonstrate that differences in the perspectives of stakeholders presents a significant barrier to the development of cohesive, culturally safe prevention programs that foster a shared knowledge of HTLV-1. The interview data suggests that a successful public health program is likely to require a dual approach that includes clinical care and community-driven health promotion. Aspects of this approach, which would raise awareness and potentially reduce transmission and lower HTLV-1 prevalence in Central Australia, may be applicable to other endemic settings with similar conditions of social disadvantage, geographic remoteness, resource limitations and cross-cultural challenges.
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Affiliation(s)
- Fiona Fowler
- Department of Social Work, Alice Salomon University of Applied Sciences, Berlin, Germany
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Legrand N, McGregor S, Bull R, Bajis S, Valencia BM, Ronnachit A, Einsiedel L, Gessain A, Kaldor J, Martinello M. Clinical and Public Health Implications of Human T-Lymphotropic Virus Type 1 Infection. Clin Microbiol Rev 2022; 35:e0007821. [PMID: 35195446 PMCID: PMC8941934 DOI: 10.1128/cmr.00078-21] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Human T-lymphotropic virus type 1 (HTLV-1) is estimated to affect 5 to 10 million people globally and can cause severe and potentially fatal disease, including adult T-cell leukemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). The burden of HTLV-1 infection appears to be geographically concentrated, with high prevalence in discrete regions and populations. While most high-income countries have introduced HTLV-1 screening of blood donations, few other public health measures have been implemented to prevent infection or its consequences. Recent advocacy from concerned researchers, clinicians, and community members has emphasized the potential for improved prevention and management of HTLV-1 infection. Despite all that has been learned in the 4 decades following the discovery of HTLV-1, gaps in knowledge across clinical and public health aspects persist, impeding optimal control and prevention, as well as the development of policies and guidelines. Awareness of HTLV-1 among health care providers, communities, and affected individuals remains limited, even in countries of endemicity. This review provides a comprehensive overview on HTLV-1 epidemiology and on clinical and public health and highlights key areas for further research and collaboration to advance the health of people with and at risk of HTLV-1 infection.
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Affiliation(s)
- Nicolas Legrand
- Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Skye McGregor
- Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Rowena Bull
- Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Sahar Bajis
- Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | | | - Amrita Ronnachit
- Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Lloyd Einsiedel
- Central Australian Health Service, Alice Springs, Northern Territory, Australia
| | - Antoine Gessain
- Institut Pasteur, Epidemiology and Physiopathology of Oncogenic Viruses Unit, Paris, France
| | - John Kaldor
- Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
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Millen S, Thoma-Kress AK. Milk Transmission of HTLV-1 and the Need for Innovative Prevention Strategies. Front Med (Lausanne) 2022; 9:867147. [PMID: 35360738 PMCID: PMC8962517 DOI: 10.3389/fmed.2022.867147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
Breastfeeding is recommended by the World Health Organization for at least 6 months up to 2 years of age, and breast milk protects against several diseases and infections. Intriguingly, few viruses are transmitted via breastfeeding including Human T-cell leukemia virus Type 1 (HTLV-1). HTLV-1 is a highly oncogenic yet neglected retrovirus, which primarily infects CD4+ T-cells in vivo and causes incurable diseases like HTLV-1-associated inflammatory conditions or Adult T-cell leukemia/lymphoma (ATLL) after lifelong viral persistence. Worldwide, at least 5–10 million people are HTLV-1-infected and most of them are unaware of their infection posing the risk of silent transmissions. HTLV-1 is transmitted via cell-containing body fluids such as blood products, semen, and breast milk, which constitutes the major route of mother-to-child transmission (MTCT). Risk of transmission increases with the duration of breastfeeding, however, abstinence from breastfeeding as it is recommended in some endemic countries is not an option in resource-limited settings or underrepresented areas and populations. Despite significant progress in understanding details of HTLV-1 cell-to-cell transmission, it is still not fully understood, which cells in which organs get infected via the oral route, how these cells get infected, how breast milk affects this route of infection and how to inhibit oral transmission despite breastfeeding, which is an urgent need especially in underrepresented areas of the world. Here, we review these questions and provide an outlook how future research could help to uncover prevention strategies that might ultimately allow infants to benefit from breastfeeding while reducing the risk of HTLV-1 transmission.
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James IC, Mejía-Mertel J, Gil Artunduaga MA, Rojas-Hernández JP. Case Series: Pediatric Human T-Lymphotropic Virus Type 1 and Its Clinical Expression. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2021.824067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PurposeHuman T-lymphotropic Virus type 1 (HTLV-1) was the first retrovirus to be identified and associated with oncogenic activity. It is estimated that approximately 10–20 million people in the world are infected with it. The clinical manifestations most commonly associated with HTLV-1 infection include T-cell leukemia/lymphoma and myelopathy associated to HTLV-1 infection. The purpose of this study is to describe clinical and demographic characteristics in pediatric patients with HTLV-1 infection.Methodology and PatientsAmbispective case series analysis, with collection of medical records and subsequent description of demographic data (sex, origin, age) and clinical characteristics in 16 patients with HTLV-1 infection were collected. Twelve of these patients were part of an initially reported cohort and four were recruited later in the study. The patients were collected between January 2017 and July 2021 in a pediatric institution in Cali, in a reference hospital in the southwest region of Colombia.ResultsThirteen of a total of sixteen patients came from the Colombian Pacific coast, where nine were with significant nutritional deficiencies. Seven showed dermatological compromise. Eight patients presented images compatible with inflammation and chronic lung injury, and six of the eight patients were with opportunistic infections. Coinfection with other microorganisms was also observed where one case presented with meningeal tuberculosis, another patient presented with simultaneous infections, namely, malaria, leptospirosis and toxoplasmosis, and a third patient presented intestinal parasitosis and soft tissue infection by Streptococcus pyogenes. Three patients had concomitant autoimmune diseases and a fourth patient was highly suspicious of having polymyositis.ConclusionsThe different clinical findings with simultaneous HTLV-1 infection broaden the panorama to suspect infection by this virus. More studies are required to achieve a direct association between structural lung disease, autoimmune diseases, immunodeficiency and HTLV-1 infection. This study aims to raise interest and awareness of an ancient but neglected disease.
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Einsiedel L, Pham H, Talukder MR, Taylor K, Wilson K, Kaldor J, Gessain A, Woodman R. Very high prevalence of infection with the human T cell leukaemia virus type 1c in remote Australian Aboriginal communities: Results of a large cross-sectional community survey. PLoS Negl Trop Dis 2021; 15:e0009915. [PMID: 34879069 PMCID: PMC8654171 DOI: 10.1371/journal.pntd.0009915] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 10/14/2021] [Indexed: 11/18/2022] Open
Abstract
Infection with the human T cell leukaemia virus type 1 (HTLV-1) subtype C is endemic among Aboriginal people in central Australia. To provide insights into the risk factors for transmission, we conducted the first large-scale, community-based prevalence study in seven remote Aboriginal communities. Residents >2 years old were invited to participate in the study between August 2014 and June 2018. HTLV-1 infection was defined as a positive western blot (WB) test or a positive HTLV-1 PCR. 720 community residents participated in the study (children <15 years, 142; adults, 578). Prevalences for children and adults were 3.5% (5/142) and 36.8% (213/578), respectively, reaching 49.3% (106/215) for those older than 45 years. A wide range of proviral loads were measured for both asymptomatic and symptomatic participants with no difference within groups according to age or gender; however, median PVL was 1.34 log10 higher for symptomatic participants. The adult prevalence of HTLV-1 infection in central Australia is the highest reported worldwide. Sexual contact is likely to be the predominant mode of transmission.
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Affiliation(s)
- Lloyd Einsiedel
- Baker Heart and Diabetes Institute, Alice Springs, Northern Territory, Australia
- * E-mail:
| | - Hai Pham
- Baker Heart and Diabetes Institute, Alice Springs, Northern Territory, Australia
| | | | - Kerry Taylor
- Poche Centre for Indigenous Health and Wellbeing, Alice Springs, Northern Territory, Australia
| | - Kim Wilson
- National Serology Reference Laboratory, Melbourne, Australia
| | - John Kaldor
- Kirby Institute, University of New South Wales, Sydney, Australia
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Avoidance of Natural Suckling from Dams with Bovine Leukemia Virus Is a Low Priority Countermeasure against Postnatal Transmission. Vet Sci 2021; 8:vetsci8110255. [PMID: 34822628 PMCID: PMC8618698 DOI: 10.3390/vetsci8110255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/13/2021] [Accepted: 10/22/2021] [Indexed: 11/16/2022] Open
Abstract
Although natural suckling from dams with bovine leukemia virus (BLV) has not been recommended in Japan, the frequency of BLV transmission through natural suckling under natural conditions is still unclear. The purpose of this study was to elucidate the risk of BLV transmission through natural suckling. Dams with BLV were classified into three groups (high, middle, low) based on the proviral loads (PVLs). PCR positivity of their colostrum and the correlations between the ratios of calves with BLV and types of feeding milk were analyzed. In dams with low PVLs, no colostrum or calves were confirmed to have BLV. In dams with middle and high PVLs, 17 out of 25 (68.0%) colostrum were PCR positive, and 10 out of 23 (43.4%) and 13 out of 29 (44.8%) calves with natural suckling and artificial rearing were infected with BLV, respectively. No difference was confirmed between the infection rates of natural-suckled and artificially reared calves. Thus, we concluded that the avoidance of natural suckling from dams with BLV and the introduction of artificial rearing were low priority countermeasures against BLV transmission.
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Rosadas C, Menezes MLB, Galvão-Castro B, Assone T, Miranda AE, Aragón MG, Caterino-de-Araujo A, Taylor GP, Ishak R. Blocking HTLV-1/2 silent transmission in Brazil: Current public health policies and proposal for additional strategies. PLoS Negl Trop Dis 2021; 15:e0009717. [PMID: 34555019 PMCID: PMC8460035 DOI: 10.1371/journal.pntd.0009717] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Human T-cell lymphotropic viruses 1 and 2 (HTLV-1/2) are relatively common in Brazil but remain silent and neglected infections. HTLV-1 is associated with a range of diseases with high morbidity and mortality. There is no curative treatment for this lifelong infection, so measures to prevent transmission are essential. This narrative review discusses HTLV-1/2 transmission routes and measures to prevent its continuous dissemination. The public health policies that are currently implemented in Brazil to avoid HTLV-1/2 transmission are addressed, and further strategies are proposed.
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Affiliation(s)
- Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Maria Luiza B. Menezes
- Departamento Materno-Infantil, Faculdade de Ciências Médicas, Universidade de Pernambuco, Pernambuco, Brazil
| | - Bernardo Galvão-Castro
- Centro Integrativo e Muldisciplinar de Atendimento ao Portador de HTLV (CHTLV), Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
| | - Tatiane Assone
- Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Angélica E. Miranda
- Programa de Pós-Graduação em Doenças Infecciosas, Universidade Federal do Espírito Santo, Espírito Santo, Brazil
| | - Mayra G. Aragón
- Programa de Pós-Graduação em Doenças Infecciosas, Universidade Federal do Espírito Santo, Espírito Santo, Brazil
| | | | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Ricardo Ishak
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Pará, Brazil
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Barouqa M, Gil MR, Sekhri R, Popoola M, Ding J, Wang Y. HTLV-1 infection in acute t- lymphocytic leukemia/lymphoma. AUTOPSY AND CASE REPORTS 2021; 11:e2021307. [PMID: 34458175 PMCID: PMC8387064 DOI: 10.4322/acr.2021.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 06/15/2021] [Indexed: 12/02/2022] Open
Abstract
Adult T- lymphocyte leukemia/ lymphoma (ATLL), described by Uchiyama et al. in 1977, is a distinct neoplasia of peripheral T-lymphocytes caused by human T-cell lymphotropic virus type 1 (HTLV-1). The authors describe the case of a 75-year-old female patient who presented with fever, chills, and altered mental status. The peripheral blood morphology showed large atypical lymphocytes with multilobed nuclei and flow cytometry consistent with ATLL. The authors discuss the pathophysiology, differential diagnosis, and subtypes of ATLL in addition to the diagnostic approach using flow cytometry when bone marrow biopsy is not available and modalities of treatment.
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Affiliation(s)
- Mohammad Barouqa
- University Hospital of Albert Einstein College of Medicine, Montefiore Medical Center, Department of Pathology, Bronx, NY, USA
| | - Morayma Reyes Gil
- University Hospital of Albert Einstein College of Medicine, Montefiore Medical Center, Department of Pathology, Bronx, NY, USA
| | - Radhika Sekhri
- University Hospital of Albert Einstein College of Medicine, Montefiore Medical Center, Department of Pathology, Bronx, NY, USA
| | - Mojisola Popoola
- University Hospital of Albert Einstein College of Medicine, Montefiore Medical Center, Department of Pathology, Bronx, NY, USA
| | - Juan Ding
- University Hospital of Albert Einstein College of Medicine, Montefiore Medical Center, Department of Pathology, Bronx, NY, USA
| | - Yanhua Wang
- University Hospital of Albert Einstein College of Medicine, Montefiore Medical Center, Department of Pathology, Bronx, NY, USA
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Itabashi K, Miyazawa T. Mother-to-Child Transmission of Human T-Cell Leukemia Virus Type 1: Mechanisms and Nutritional Strategies for Prevention. Cancers (Basel) 2021; 13:cancers13164100. [PMID: 34439253 PMCID: PMC8394315 DOI: 10.3390/cancers13164100] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/29/2021] [Accepted: 08/13/2021] [Indexed: 12/17/2022] Open
Abstract
Approximately 95% of mother-to-child transmission (MTCT) of human T-cell leukemia virus type-1 (HTLV-1) is derived from prolonged breastfeeding, which is a major cause of adult T-cell leukemia (ATL). Exclusive formula feeding (ExFF) is therefore generally used to prevent MTCT. A recent cohort study revealed that 55% of pregnant carriers chose short-term breastfeeding for ≤3 months in Japan. Our meta-analysis showed that there was no significant increase in the risk of MTCT when breastfeeding was carried out for ≤3 months compared with ExFF (pooled relative risk (RR), 0.72; 95% confidence interval (CI), 0.30-1.77), but there was an almost threefold increase in risk when breastfeeding was carried out for up to 6 months (pooled RR, 2.91; 95% CI, 1.69-5.03). Thus, short-term breastfeeding for ≤3 months may be useful in preventing MTCT. Breastmilk is the best nutritional source for infants, and any approach to minimizing MTCT by avoiding or limiting breastfeeding must be balanced against the impact on the child's health and mother-child bonding. To minimize the need for nutritional interventions, it is necessary to identify factors that predispose children born to carrier mothers to MTCT and thereby predict MTCT development with a high degree of accuracy.
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Affiliation(s)
- Kazuo Itabashi
- Aiseikai Memorial Ibaraki Welfare Medical Center, 1872-1 Motoyoshida-cho, Mito-City 310-0836, Japan
- Department of Pediatrics, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan;
- Correspondence: ; Tel.: +81-29-353-7171; Fax: +81-29-353-6112
| | - Tokuo Miyazawa
- Department of Pediatrics, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan;
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Vieira BA, Bidinotto AB, Dartora WJ, Pedrotti LG, de Oliveira VM, Wendland EM. Prevalence of human T-lymphotropic virus type 1 and 2 (HTLV-1/-2) infection in pregnant women in Brazil: a systematic review and meta-analysis. Sci Rep 2021; 11:15367. [PMID: 34321555 PMCID: PMC8319321 DOI: 10.1038/s41598-021-94934-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/05/2021] [Indexed: 01/17/2023] Open
Abstract
Human T-lymphotropic virus type 1 (HTLV-1) infection may cause serious disease, while pathogenicity of HTLV-2 is less certain. There are no screening or surveillance programs for HTLV-1/-2 infection in Brazil. By performing this systematic review, we aimed to estimate the prevalence of HTLV-1/-2 infections in pregnant women in Brazil. This review included cohort and cross-sectional studies that assessed the presence of either HTLV-1/-2 infection in pregnant women in Brazil. We searched BVS/LILACS, Cochrane Library/CENTRAL, EMBASE, PubMed/MEDLINE, Scopus, Web of Science and gray literature from inception to August 2020. We identified 246 records in total. Twenty-six of those were included in the qualitative synthesis, while 17 of them were included in the meta-analysis. The prevalence of HTLV-1 in Brazilian pregnant women, as diagnosed by a positive screening test and a subsequent positive confirmatory test, was 0.32% (95% CI 0.19-1.54), while of HTLV-2 was 0.04% (95% CI 0.02-0.08). Subgroup analysis by region showed the highest prevalence in the Northeast region (0.60%; 95% CI 0.37-0.97) for HTLV-1 and in the South region (0.16%; 95% CI 0.02-1.10) for HTLV-2. The prevalence of HTLV-1 is much higher than HTLV-2 infection in pregnant Brazilian women with important differences between regions. The prevalence of both HTLV-1/-2 are higher in the Northeast compared to Center-West region.
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Affiliation(s)
| | | | | | | | | | - Eliana Márcia Wendland
- Hospital Moinhos de Vento, Porto Alegre, Brazil.
- Public Health Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.
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Desgraupes S, Hubert M, Gessain A, Ceccaldi PE, Vidy A. Mother-to-Child Transmission of Arboviruses during Breastfeeding: From Epidemiology to Cellular Mechanisms. Viruses 2021; 13:1312. [PMID: 34372518 PMCID: PMC8310101 DOI: 10.3390/v13071312] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/18/2021] [Accepted: 06/30/2021] [Indexed: 12/20/2022] Open
Abstract
Most viruses use several entry sites and modes of transmission to infect their host (parenteral, sexual, respiratory, oro-fecal, transplacental, transcutaneous, etc.). Some of them are known to be essentially transmitted via arthropod bites (mosquitoes, ticks, phlebotomes, sandflies, etc.), and are thus named arthropod-borne viruses, or arboviruses. During the last decades, several arboviruses have emerged or re-emerged in different countries in the form of notable outbreaks, resulting in a growing interest from scientific and medical communities as well as an increase in epidemiological studies. These studies have highlighted the existence of other modes of transmission. Among them, mother-to-child transmission (MTCT) during breastfeeding was highlighted for the vaccine strain of yellow fever virus (YFV) and Zika virus (ZIKV), and suggested for other arboviruses such as Chikungunya virus (CHIKV), dengue virus (DENV), and West Nile virus (WNV). In this review, we summarize all epidemiological and clinical clues that suggest the existence of breastfeeding as a neglected route for MTCT of arboviruses and we decipher some of the mechanisms that chronologically occur during MTCT via breastfeeding by focusing on ZIKV transmission process.
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Affiliation(s)
- Sophie Desgraupes
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, 75015 Paris, France; (M.H.); (A.G.); (P.-E.C.)
- Université de Paris, 75013 Paris, France
- UMR Centre National de la Recherche Scientifique 3569, Institut Pasteur, 75015 Paris, France
| | - Mathieu Hubert
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, 75015 Paris, France; (M.H.); (A.G.); (P.-E.C.)
- Université de Paris, 75013 Paris, France
- UMR Centre National de la Recherche Scientifique 3569, Institut Pasteur, 75015 Paris, France
| | - Antoine Gessain
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, 75015 Paris, France; (M.H.); (A.G.); (P.-E.C.)
- Université de Paris, 75013 Paris, France
- UMR Centre National de la Recherche Scientifique 3569, Institut Pasteur, 75015 Paris, France
| | - Pierre-Emmanuel Ceccaldi
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, 75015 Paris, France; (M.H.); (A.G.); (P.-E.C.)
- Université de Paris, 75013 Paris, France
- UMR Centre National de la Recherche Scientifique 3569, Institut Pasteur, 75015 Paris, France
| | - Aurore Vidy
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, 75015 Paris, France; (M.H.); (A.G.); (P.-E.C.)
- Université de Paris, 75013 Paris, France
- UMR Centre National de la Recherche Scientifique 3569, Institut Pasteur, 75015 Paris, France
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Van de Perre P, Molès J, Nagot N, Tuaillon E, Ceccaldi P, Goga A, Prendergast AJ, Rollins N. Revisiting Koch's postulate to determine the plausibility of viral transmission by human milk. Pediatr Allergy Immunol 2021; 32:835-842. [PMID: 33594740 PMCID: PMC8359252 DOI: 10.1111/pai.13473] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 12/18/2022]
Abstract
As breastfeeding is of utmost importance for child development and survival, identifying whether breast milk is a route of transmission for human viruses is critical. Based on the principle of Koch's postulate, we propose an analytical framework to determine the plausibility of viral transmission by breast milk. This framework is based on five criteria: viral infection in children receiving breast milk from infected mothers; the presence of virus, viral antigen, or viral genome in the breast milk of infected mothers; the evidence for the virus in breast milk being infectious; the attempts to rule out other transmission modalities; and the reproduction of viral transmission by oral inoculation in an animal model. We searched for evidence in published reports to determine whether the 5 criteria are fulfilled for 16 human viruses that are suspected to be transmissible by breast milk. We considered breast milk transmission is proven if all 5 criteria are fulfilled, as probable if 4 of the 5 criteria are met, as possible if 3 of the 5 criteria are fulfilled, and as unlikely if less than 3 criteria are met. Only five viruses have proven transmission through breast milk: human T-cell lymphotropic virus 1, human immunodeficiency virus, human cytomegalovirus, dengue virus, and Zika virus. The other 11 viruses fulfilled some but not all criteria and were categorized accordingly. Our framework analysis is useful for guiding public health recommendations and for identifying knowledge gaps amenable to original experiments.
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Affiliation(s)
- Philippe Van de Perre
- Pathogenesis and Control of Chronic and Emerging InfectionsUniversity of MontpellierINSERMEtablissement Français du SangAntilles UniversityMontpellierFrance
- CHU MontpellierMontpellierFrance
| | - Jean‐Pierre Molès
- Pathogenesis and Control of Chronic and Emerging InfectionsUniversity of MontpellierINSERMEtablissement Français du SangAntilles UniversityMontpellierFrance
- CHU MontpellierMontpellierFrance
| | - Nicolas Nagot
- Pathogenesis and Control of Chronic and Emerging InfectionsUniversity of MontpellierINSERMEtablissement Français du SangAntilles UniversityMontpellierFrance
- CHU MontpellierMontpellierFrance
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic and Emerging InfectionsUniversity of MontpellierINSERMEtablissement Français du SangAntilles UniversityMontpellierFrance
- CHU MontpellierMontpellierFrance
| | - Pierre‐Emmanuel Ceccaldi
- Unité Epidémiologie et Physiopathologie des Virus OncogènesCNRS UMR 3569Institut PasteurUniversité de ParisParisFrance
| | - Ameena Goga
- HIV Prevention Research UnitSouth African Medical Research CouncilCape TownSouth Africa
- Department of Paediatrics and Child HealthUniversity of PretoriaPretoriaSouth Africa
| | - Andrew J. Prendergast
- Blizard InstituteQueen Mary University of LondonUK
- Zvitambo Institute for Maternal and Child Health ResearchHarareZimbabwe
| | - Nigel Rollins
- Department of Maternal, Newborn, Child and Adolescent Health and AgeingWorld Health OrganizationGenevaSwitzerland
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Rosadas C, Brites C, Arakaki-Sanchez D, Casseb J, Ishak R. Brazilian Protocol for Sexually Transmitted Infections 2020: human T-cell lymphotropic virus (HTLV) infection. Rev Soc Bras Med Trop 2021; 54:e2020605. [PMID: 34008723 PMCID: PMC8210483 DOI: 10.1590/0037-8682-605-2020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/10/2021] [Indexed: 12/26/2022] Open
Abstract
This article addresses the Human T-lymphotropic virus (HTLV). This subject comprises the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health. HTLV-1/2 infection is a public health problem globally, and Brazil has the largest number of individuals living with the virus. HTLV-1 causes several clinical manifestations of neoplasm (adult T-cell leukemia/lymphoma) and inflammatory nature, such as HTLV-1-associated myelopathy and other manifestations such as uveitis, arthritis, and infective dermatitis. These pathologies have high morbidity and mortality and negatively impact the quality of life of infected individuals. This review includes relevant information for health authorities professionals regarding viral transmission, diagnosis, treatment, and monitoring of individuals living with HTLV-1 and 2 in Brazil. HTLV-1/2 transmission can occur through blood transfusion and derivatives, injectable drug use, organ transplantation, unprotected sexual intercourse, and vertical transmission.
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Affiliation(s)
- Carolina Rosadas
- Imperial College London, Department of Infectious Disease, London, United Kingdom
| | - Carlos Brites
- Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brasil
| | | | - Jorge Casseb
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brasil
| | - Ricardo Ishak
- Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém, PA, Brasil
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Olindo S, Jeannin S, Lezin A. Manifestazioni neurologiche legate all’“human T-cell leukemia/lymphoma virus” tipo 1 (HTLV-1). Neurologia 2021. [DOI: 10.1016/s1634-7072(21)44999-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Ahmadi Ghezeldasht S, Shamsian SAA, Gholizadeh Navashenaq J, Miri R, Ashrafi F, Mosavat A, Rezaee SA. HTLV-1 oncovirus-host interactions: From entry to the manifestation of associated diseases. Rev Med Virol 2021; 31:e2235. [PMID: 33742509 DOI: 10.1002/rmv.2235] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/03/2021] [Accepted: 03/03/2021] [Indexed: 12/19/2022]
Abstract
Human T lymphotropic virus type-1 (HTLV-1) is a well-known human oncovirus, associated with two life-threatening diseases, adult T cell leukaemia/lymphoma (ATL) and HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). The study of this oncogenic virus is significant from two different aspects. First, HTLV-1 can be considered as a neglected public health problem, which may spread slowly worldwide. Second, the incidence of HTLV-1 associated diseases due to oncogenic effects and deterioration of the immune system towards autoimmune diseases are not fully understood. Furthermore, knowledge about viral routes of transmission is important for considering potential interventions, treatments or vaccines in endemic regions. In this review, novel characteristics of HTLV-1, such as the unusual infectivity of virions through the virological synapse, are discussed in the context of the HTLV-1 associated diseases (ATL and HAM/TSP).
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Affiliation(s)
- Sanaz Ahmadi Ghezeldasht
- Inflammation and Inflammatory Diseases Division, Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Ali Akbar Shamsian
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Mashhad, Iran
| | | | - Raheleh Miri
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Mashhad, Iran
| | - Fereshteh Ashrafi
- Department of Animal Science, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Arman Mosavat
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Mashhad, Iran
| | - Seyed Abdolrahim Rezaee
- Inflammation and Inflammatory Diseases Division, Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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37
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Rosadas C, Brites C, Arakaki-Sánchez D, Casseb J, Ishak R. [Brazilian Protocol for Sexually Transmitted Infections 2020: human T cell lymphotropic virus (HTLV) infection]. ACTA ACUST UNITED AC 2021; 30:e2020605. [PMID: 33729406 DOI: 10.1590/s1679-497420200006000015.esp1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/07/2020] [Indexed: 11/22/2022]
Abstract
This manuscript is related to the chapter about human T-cell lymphotropic virus (HTLV) that is part of the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Health Ministry. HTLV-1/2 infection is a worldwide public health problem and Brazil has the largest number of individuals living with the virus. HTLV-1 causes a variety of clinical manifestations of a neoplastic nature, such as adult leukemia/T-cell lymphoma, and also of an inflammatory nature, such as HTLV-1-associated myelopathy, as well as other manifestations such as uveitis, arthritis and infective dermatitis. These pathologies have high morbidity and mortality and negatively impact the quality of life of infected individuals. This review includes relevant information for health service managers and workers regarding virus transmission modes, diagnosis, treatment and monitoring of individuals living with HTLV-1 and 2 in Brazil.
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Affiliation(s)
- Carolina Rosadas
- Imperial College London, Department of Infectious Disease, Londres, Reino Unido
| | - Carlos Brites
- Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brasil
| | | | - Jorge Casseb
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brasil
| | - Ricardo Ishak
- Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém, PA, Brasil
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Itabashi K, Miyazawa T, Nerome Y, Sekizawa A, Moriuchi H, Saito S, Yonemoto N. Issues of infant feeding for postnatal prevention of human T-cell leukemia/lymphoma virus type-1 mother-to-child transmission. Pediatr Int 2021; 63:284-289. [PMID: 32574414 DOI: 10.1111/ped.14356] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/10/2020] [Accepted: 06/17/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Nationwide antenatal human T-cell leukemia/lymphoma virus type-1 (HTLV-1) antibody screening has been conducted in Japan. The purpose of our study was to clarify the issues related to feeding options to prevent postnatal mother-to-child transmission. METHODS Of the pregnant carriers at 92 facilities in Japan between 2012 and 2015, 735 were followed prospectively. Among the children born to them, 313 (42.6%) children were followed up to the age of 3 and tested for HTLV-1 antibodies. The mother-to-child transmission rate was calculated for each feeding option selected before birth. RESULTS Among the 313 pregnant carriers, 55.0, 35.1, 6.1, and 3.8% selected short-term breast-feeding (≤3 months), exclusive formula feeding, frozen-thawed breast-milk feeding, and longer-term breast-feeding, respectively. Despite short-term breast-feeding, 8-18% of the mothers continued breast-feeding for 4-6 months. The mother-to-child transmission rate with short-term breast-feeding was 2.3% (4/172), and its risk ratio compared with that of exclusive formula feeding was not significantly different (0.365; 95% CI: 0.116-1.145). Because of the small number of children who were fed by frozen-thawed breast-milk, their mother-to-child transmission rate was not statistically reliable. CONCLUSIONS Pregnant HTLV-1 carriers tended to select short-term breast-feeding in Japan. While short-term breast-feeding was not always easy to wean within 3 months, it may be a viable option for preventing postnatal mother-to-child transmission because the vertical transmission rate with short-term breast-feeding was not significantly higher than that with exclusive formula feeding. Increasing the follow-up rates for children born to pregnant carriers may provide clearer evidence of preventative effects by short-term breast-feeding and frozen-thawed breast-milk feeding.
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Affiliation(s)
| | - Tokuo Miyazawa
- Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan
| | - Yasuhito Nerome
- Faculty of Medicine, Kagoshima University School of Health Sciences, Kagoshima, Japan
| | - Akihiko Sekizawa
- Japan Association of Obstetricians and Gynecologists, Tokyo, Japan
| | - Hiroyuki Moriuchi
- Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Naohiro Yonemoto
- Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
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Tezuka K, Fuchi N, Okuma K, Tsukiyama T, Miura S, Hasegawa Y, Nagata A, Komatsu N, Hasegawa H, Sasaki D, Sasaki E, Mizukami T, Kuramitsu M, Matsuoka S, Yanagihara K, Miura K, Hamaguchi I. HTLV-1 targets human placental trophoblasts in seropositive pregnant women. J Clin Invest 2021; 130:6171-6186. [PMID: 33074247 DOI: 10.1172/jci135525] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 08/06/2020] [Indexed: 12/19/2022] Open
Abstract
Human T cell leukemia virus type 1 (HTLV-1) is mainly transmitted vertically through breast milk. The rate of mother-to-child transmission (MTCT) through formula feeding, although significantly lower than through breastfeeding, is approximately 2.4%-3.6%, suggesting the possibility of alternative transmission routes. MTCT of HTLV-1 might occur through the uterus, birth canal, or placental tissues; the latter is known as transplacental transmission. Here, we found that HTLV-1 proviral DNA was present in the placental villous tissues of the fetuses of nearly half of pregnant carriers and in a small number of cord blood samples. An RNA ISH assay showed that HTLV-1-expressing cells were present in nearly all subjects with HTLV-1-positive placental villous tissues, and their frequency was significantly higher in subjects with HTLV-1-positive cord blood samples. Furthermore, placental villous trophoblasts expressed HTLV-1 receptors and showed increased susceptibility to HTLV-1 infection. In addition, HTLV-1-infected trophoblasts expressed high levels of viral antigens and promoted the de novo infection of target T cells in a humanized mouse model. In summary, during pregnancy of HTLV-1 carriers, HTLV-1 was highly expressed in placental villous tissues, and villous trophoblasts showed high HTLV-1 sensitivity, suggesting that MTCT of HTLV-1 occurs through the placenta.
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Affiliation(s)
- Kenta Tezuka
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Naoki Fuchi
- Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazu Okuma
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takashi Tsukiyama
- Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shoko Miura
- Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yuri Hasegawa
- Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ai Nagata
- Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Nahoko Komatsu
- Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroo Hasegawa
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Daisuke Sasaki
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Eita Sasaki
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takuo Mizukami
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Madoka Kuramitsu
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Sahoko Matsuoka
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Kiyonori Miura
- Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Isao Hamaguchi
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
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Motedayen Aval L, Boullier M, Lyall H, Collins GP, Ayto R, Kelly DF, Tedder RS, Drysdale SB, Taylor GP, Cook LB. Adult T cell leukaemia/lymphoma (ATL) in pregnancy: A UK case series. EJHAEM 2021; 2:131-135. [PMID: 35846087 PMCID: PMC9175930 DOI: 10.1002/jha2.142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/12/2020] [Accepted: 11/12/2020] [Indexed: 01/17/2023]
Abstract
Introduction Chronic infection with human T-cell lymphotropic virus type-1 (HTLV-1) may result in aggressive adult T-cell leukaemia/lymphoma (ATL) in 4-6% carriers. The majority of this risk arises in carriers infected during infancy, and so each infant has ∼25% lifetime risk. Other risk factors include a family history of ATL. Antenatal HTLV-1 screening is not undertaken in the UK. Methods Here we describe four cases of ATL diagnosed during pregnancy and describe strategies to minimise HTLV-1 transmission to neonates. Results/conclusion These cases highlight undiagnosed HTLV-1 in pregnancy which allows ongoing mother to child vertical transmission and risk of future ATL. We recommend the UK National Screening Committee incorporate HTLV-1 serology into antenatal screening.
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Affiliation(s)
| | - Mary Boullier
- Department of PaediatricsSt George's University Hospitals NHS Foundation TrustLondonUK
| | - Hermione Lyall
- Department of Paediatric Infectious DiseasesImperial College Healthcare NHS TrustLondonUK
| | - Graham P. Collins
- Department of HaematologyOxford University Hospitals NHS Foundation TrustOxfordUK
| | - Robert Ayto
- Department of HaematologyPortsmouth Hospitals NHS TrustHampshireUK
| | - Dominic F. Kelly
- Oxford Vaccine GroupDepartment of PaediatricsUniversity of OxfordOxfordUK
- NIHR Oxford Biomedical Research CentreOxfordUK
| | | | - Simon B. Drysdale
- Department of PaediatricsSt George's University Hospitals NHS Foundation TrustLondonUK
- Oxford Vaccine GroupDepartment of PaediatricsUniversity of OxfordOxfordUK
| | - Graham P. Taylor
- Section of Virology, Imperial CollegeLondonUK
- National Centre for Human RetrovirologyImperial College Healthcare NHS TrustLondonUK
| | - Lucy B. Cook
- Section of Virology, Imperial CollegeLondonUK
- Centre for HaematologyImperial College Healthcare NHS TrustLondonUK
- National Centre for Human RetrovirologyImperial College Healthcare NHS TrustLondonUK
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Sagara Y, Nakamura H, Yamamoto M, Ezaki T, Koga T, Shimamura M, Satake M, Irita K. Estimation of the window period of human T-cell leukemia virus type 1 and 2 tests by a lookback study of seroconverters among Japanese voluntary blood donors. Transfusion 2020; 61:484-493. [PMID: 33368334 DOI: 10.1111/trf.16213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Japan is endemic for human T-cell leukemia virus type 1 (HTLV-1), and the horizontal transmission of HTLV-1 is often reported. However, the window period (WP) for serologic or molecular screening is unclear. STUDY DESIGN AND METHODS Results for anti-HTLV-1 screening and confirmatory tests obtained from 648 591 repeated blood donors in the Kyushu district, one of the most endemic areas of HTLV-1 in the world, were evaluated. A lookback study was conducted for seroconverters. RESULTS During 2012 to 2019, 436 seroconverters (155 men, 281women) were identified with use of a screening chemiluminescence enzyme-immunoassay (CLEIA) and multiple confirmatory tests. Because the period between the latest seronegative donation and seroconversion was highly variable (2.1-276.7 months), 19 cases that seroconverted within 6 months were subjected to the analysis. The WP of the particle agglutination assay and CLEIA was estimated to be 2.2 ± 0.6 and 2.6 ± 1.7 months, respectively. The WP of the indirect immunofluorescence assay was 4.8 ± 6.5 months. Although the WP of western blotting was estimated to be 6.3 ± 8.7 months, four cases were still indeterminate through the study period. Chemiluminescence and line immunoassays, the current screening and confirmatory tests used in the Japanese blood program, showed the shortest WP of 2.2 ± 0.6 months. The WP of real-time polymerase chain reaction for HTLV-1 was estimated to be 4.1 ± 7.8 months. CONCLUSIONS The WP in commercially available testing systems for HTLV-1/2 was determined for natural infection among repeated blood donors. Considering the HTLV-1 WP will help increase transfusion safety and facilitate the accurate diagnosis of HTLV-1 infection.
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Affiliation(s)
- Yasuko Sagara
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Chikushino, Japan
| | - Hitomi Nakamura
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Chikushino, Japan
| | - Midori Yamamoto
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Chikushino, Japan
| | - Toshinobu Ezaki
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Chikushino, Japan
| | - Tomohide Koga
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Chikushino, Japan
| | - Masuhiro Shimamura
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Chikushino, Japan
| | - Masahiro Satake
- CEO of Japanese Red Cross Central Blood Institute, Tokyo, Japan
| | - Kazuo Irita
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Chikushino, Japan
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Al Sharif S, Pinto DO, Mensah GA, Dehbandi F, Khatkar P, Kim Y, Branscome H, Kashanchi F. Extracellular Vesicles in HTLV-1 Communication: The Story of an Invisible Messenger. Viruses 2020; 12:E1422. [PMID: 33322043 PMCID: PMC7763366 DOI: 10.3390/v12121422] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 02/08/2023] Open
Abstract
Human T-cell lymphotropic virus type 1 (HTLV-1) infects 5-10 million people worldwide and is the causative agent of adult T-cell leukemia/lymphoma (ATLL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) as well as other inflammatory diseases. A major concern is that the most majority of individuals with HTLV-1 are asymptomatic carriers and that there is limited global attention by health care officials, setting up potential conditions for increased viral spread. HTLV-1 transmission occurs primarily through sexual intercourse, blood transfusion, intravenous drug usage, and breast feeding. Currently, there is no cure for HTLV-1 infection and only limited treatment options exist, such as class I interferons (IFN) and Zidovudine (AZT), with poor prognosis. Recently, small membrane-bound structures, known as extracellular vesicles (EVs), have received increased attention due to their potential to carry viral cargo (RNA and proteins) in multiple pathogenic infections (i.e., human immunodeficiency virus type I (HIV-1), Zika virus, and HTLV-1). In the case of HTLV-1, EVs isolated from the peripheral blood and cerebral spinal fluid (CSF) of HAM/TSP patients contained the viral transactivator protein Tax. Additionally, EVs derived from HTLV-1-infected cells (HTLV-1 EVs) promote functional effects such as cell aggregation which enhance viral spread. In this review, we present current knowledge surrounding EVs and their potential role as immune-modulating agents in cancer and other infectious diseases such as HTLV-1 and HIV-1. We discuss various features of EVs that make them prime targets for possible vehicles of future diagnostics and therapies.
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Affiliation(s)
| | | | | | | | | | | | | | - Fatah Kashanchi
- Laboratory of Molecular Virology, George Mason University, Manassas, VA 20110, USA; (S.A.S.); (D.O.P.); (G.A.M.); (F.D.); (P.K.); (Y.K.); (H.B.)
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Aben-Athar CYUP, Pinto DDS, Lima SS, Vallinoto IMVC, Ishak R, Vallinoto ACR. Limitations in daily activities, risk awareness, social participation, and pain in patients with HTLV-1 using the SALSA and Participation scales. Braz J Infect Dis 2020; 24:497-504. [PMID: 32941806 PMCID: PMC9392093 DOI: 10.1016/j.bjid.2020.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/03/2020] [Accepted: 08/16/2020] [Indexed: 12/14/2022] Open
Abstract
Background Tropical spastic paraparesis or HTLV-associated myelopathy (TSP/HAM) may prevent, limit or restrict the performance of daily living activities, and as a consequence, several aspects of life are affected. Objective The aim of this study was to evaluate activity limitations, risk awareness, social participation, quality of life, and pain in individuals infected with HTLV-1. Methods This was an observational, descriptive, analytical, cross-sectional study with a quantitative approach. An interview questionnaire, the Screening of Activity Limitation and Safety Awareness (SALSA) scale, the Participation scale, a quality of life questionnaire (SF-36) and the Brief Pain Inventory were used. Results A total of 55 patients with HTLV-1 were interviewed (62% asymptomatic and 38% symptomatic). In both groups, there was a higher frequency of patients aged 41–50 years old (35.3% asymptomatic and 38.1% symptomatic), with complete secondary education (47.1% asymptomatic and 42.9% symptomatic), and married (64.7% asymptomatic and 52.4% symptomatic). Of the symptomatic patients, 33.3% were retired; among asymptomatic patients, 20.6% performed domestic activities. The majority of patients in both groups had not received blood transfusions. Sexual intercourse was still practiced by patients. After assessment, asymptomatic patients had no activity limitations (64.7%), and symptomatic patients presented limitations (90.5%). None of the groups showed good risk awareness. There was no restriction on social participation in 97.1% of asymptomatic patients and in 52.4% among symptomatics. Both groups complained of pain, being more frequent in the lumbar spine in asymptomatic patients and in the knees in symptomatic patients. Pain was more severe in symptomatic patients and affected aspects of quality of life. Conclusion The clinical follow-up instruments must be adopted by healthcare professionals to monitor new symptoms so as to avoid the onset of limitations identified in symptomatic patients, in addition to enabling continuous surveillance of asymptomatic patients.
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Affiliation(s)
| | - Denise da Silva Pinto
- Universidade Federal do Pará, Instituto de Ciências da Saúde, Laboratório de Estudos em Reabilitação Funcional (LAERF), Belém, PA, Brazil
| | - Sandra Souza Lima
- Universidade Federal do Pará, Instituto de Ciências Biológicas, Laboratório de Virologia, Pará, PA, Brazil
| | | | - Ricardo Ishak
- Universidade Federal do Pará, Instituto de Ciências Biológicas, Laboratório de Virologia, Pará, PA, Brazil
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Maali Y, Journo C, Mahieux R, Dutartre H. Microbial Biofilms: Human T-cell Leukemia Virus Type 1 First in Line for Viral Biofilm but Far Behind Bacterial Biofilms. Front Microbiol 2020; 11:2041. [PMID: 33042035 PMCID: PMC7523422 DOI: 10.3389/fmicb.2020.02041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/03/2020] [Indexed: 12/25/2022] Open
Abstract
Human T-cell leukemia virus type 1 (HTLV-1) is a retrovirus associated with adult T-cell leukemia (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). To date, it is the unique published example of a virus able to form a biofilm at the surface of infected cells. Deeply studied in bacteria, bacterial biofilms represent multicellular assemblies of bacteria in contact with a surface and shielded by the extracellular matrix (ECM). Microbial lifestyle in biofilms, either viral or bacterial, is opposed structurally and physiologically to an isolated lifestyle, in which viruses or bacteria freely float in their environment. HTLV-1 biofilm formation is believed to be promoted by viral proteins, mainly Tax, through remodeling of the ECM of the infected cells. HTLV-1 biofilm has been linked to cell-to-cell transmission of the virus. However, in comparison to bacterial biofilms, very little is known on kinetics of viral biofilm formation or dissemination, but also on its pathophysiological roles, such as escape from immune detection or therapeutic strategies, as well as promotion of leukemogenesis. The switch between production of cell-free isolated virions and cell-associated viral biofilm, although not fully apprehended yet, remains a key step to understand HTLV-1 infection and pathogenesis.
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Affiliation(s)
- Yousef Maali
- CIRI - Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Lyon, France
| | - Chloé Journo
- CIRI - Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Lyon, France
| | - Renaud Mahieux
- CIRI - Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Lyon, France
| | - Hélène Dutartre
- CIRI - Centre International de Recherche en Infectiologie, Univ Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, Lyon, France
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Prendergast AJ, Goga AE, Waitt C, Gessain A, Taylor GP, Rollins N, Abrams EJ, Lyall EH, de Perre PV. Transmission of CMV, HTLV-1, and HIV through breastmilk. THE LANCET CHILD & ADOLESCENT HEALTH 2020; 3:264-273. [PMID: 30878119 DOI: 10.1016/s2352-4642(19)30024-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 12/14/2022]
Abstract
Breastfeeding is a crucial child survival intervention. However, the potential for transmission of viral infections from mother to child presents the dilemma of how best to interpret the benefits and risks of breastfeeding in different settings. In this Review, we compare the transmission dynamics, risk factors, and outcomes of infection with three chronic viruses transmitted through breastmilk: cytomegalovirus, human T-cell lymphotropic virus type 1, and HIV. We provide an overview of intervention approaches and discuss scientific, policy, and programming gaps in the understanding of these major global infections.
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Affiliation(s)
- Andrew J Prendergast
- Blizard Institute, Queen Mary University of London, London, UK; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.
| | - Ameena E Goga
- South African Medical Research Council, Cape Town, South Africa; Department of Paediatrics, University of Pretoria, Hatfield, South Africa
| | - Catriona Waitt
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK; Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | | | | | - Nigel Rollins
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
| | - Elaine J Abrams
- ICAP at Columbia, Mailman School of Public Health, and Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - E Hermione Lyall
- Department of Paediatrics, Imperial College Healthcare NHS Trust, London, UK
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic Infection, INSERM, University Montpellier, Etablissement Français du Sang, CHU de Montpellier, Montpellier, France
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Towards the elimination of HTLV-1 infection in Japan. THE LANCET. INFECTIOUS DISEASES 2020; 19:15-16. [PMID: 30587282 DOI: 10.1016/s1473-3099(18)30735-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 11/22/2018] [Indexed: 11/23/2022]
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Ramassamy JL, Cassar O, Toumbiri M, Diané A, Idam Mamimandjiami A, Bengone C, Ntsame-Ndong JM, Mouinga-Ondémé A, Gessain A. High prevalence of human T-cell leukemia virus type-1b genotype among blood donors in Gabon, Central Africa. Transfusion 2020; 60:1483-1491. [PMID: 32415686 PMCID: PMC7496943 DOI: 10.1111/trf.15838] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 02/26/2020] [Accepted: 03/22/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND The African continent is considered to be the largest endemic area of HTLV‐1 infection, with at least several million infected individuals. Systematic screening of blood donors can prevent the transmission of HTLV‐1 in blood. Gabon is one of the countries with the highest prevalence of HTLV‐1 worldwide, and yet the routine testing of blood donors has still not been introduced. METHODS All blood donations collected between April and July 2017 at the Centre National de Transfusion Sanguine of Gabon were studied. Plasma samples were screened by ELISA for the presence of HTLV‐1/2 antibodies. Western blot (WB) and polymerase chain reaction (PCR) tests were used for confirmation. RESULTS In total, 3123 blood donors were tested, including 1740 repeat and 1378 first‐time blood donors (FTBDs). Of them, 132 samples tested positive for HTLV‐1/2 by ELISA (4.2%). WB and PCR confirmed HTLV‐1 infection for 23 individuals. The overall prevalence of HTLV‐1 was 0.74% [95% CI 0.47%‐1.10%], 1% in FTBD, and 0.5% in repeat donors. Age and sex‐adjusted prevalence was five‐fold lower in FTBD than in the general adult population of rural areas of Gabon. All detected HTLV‐1 strains belonged to the central African HTLV‐1b genotype but were highly diverse. CONCLUSION We report an overall prevalence of HTLV‐1 of 0.74%, one of the highest values reported for blood donors in Africa. Given the high risk of HTLV‐1 transmission in blood, it is necessary to conduct cost‐effectiveness studies to determine the need and feasibility of implementing screening of HTLV‐1 in blood donors in Gabon.
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Affiliation(s)
- Jill-Léa Ramassamy
- Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Institut Pasteur, UMR 3569, CNRS, Paris, France.,Université de Paris, Paris, France
| | - Olivier Cassar
- Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Institut Pasteur, UMR 3569, CNRS, Paris, France
| | - Manoushka Toumbiri
- Unité des infections rétrovirales et pathologies associées, Centre International de Recherches Médicales de Franceville, Franceville, Gabon
| | - Abdoulaye Diané
- Unité des infections rétrovirales et pathologies associées, Centre International de Recherches Médicales de Franceville, Franceville, Gabon
| | - Antony Idam Mamimandjiami
- Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Institut Pasteur, UMR 3569, CNRS, Paris, France.,Unité des infections rétrovirales et pathologies associées, Centre International de Recherches Médicales de Franceville, Franceville, Gabon.,Ecole Doctorale Régionale d'Afrique Centrale, Infectiologie Tropicale, Franceville, Gabon
| | - Calixte Bengone
- Centre National de Transfusion sanguine (CNTS), Libreville, Gabon
| | | | - Augustin Mouinga-Ondémé
- Unité des infections rétrovirales et pathologies associées, Centre International de Recherches Médicales de Franceville, Franceville, Gabon
| | - Antoine Gessain
- Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Institut Pasteur, UMR 3569, CNRS, Paris, France
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Itabashi K, Miyazawa T, Sekizawa A, Tokita A, Saito S, Moriuchi H, Nerome Y, Uchimaru K, Watanabe T. A Nationwide Antenatal Human T-Cell Leukemia Virus Type-1 Antibody Screening in Japan. Front Microbiol 2020; 11:595. [PMID: 32328047 PMCID: PMC7160230 DOI: 10.3389/fmicb.2020.00595] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 03/18/2020] [Indexed: 12/26/2022] Open
Abstract
Japan has been running a nationwide antenatal human T-cell leukemia virus type-1 (HTLV-1) antibody screening program since 2010 for the prevention of HTLV-1 mother-to-child transmission. As part of the program, pregnant women are invited to take an HTLV-1 antibody screening test, usually within the first 30 weeks of gestation, during regular pregnancy checkups. Pregnant women tested positive on the antibody screening test undergo a confirmatory test, either western blotting or line immunoassay. In indeterminate case, polymerase chain reaction (PCR) is used as a final test to diagnose infection. Pregnant women tested positive on a confirmatory or PCR test are identified as HTLV-1 carriers. As breastfeeding is a predominant route of postnatal HTLV-1 mother-to-child transmission, exclusive formula feeding is widely used as a postnatal preventive measure. Although there is insufficient evidence that short-term breastfeeding during ≤3 months does not increase the risk of mother-to-child transmission compared to exclusive formula feeding, this feeding method is considered if the mother is eager to breastfeed her child. However, it is important that mothers and family members fully understand that there is an increase in the risk of mother-to-child transmission when breastfeeding would be prolonged. As there are only a few clinical studies on the protective effect of frozen-thawed breastmilk feeding on mother-to-child transmission of HTLV-1, there is little evidence to recommend this feeding method. Further study on the protective effects of these feeding methods are needed. It is assumed that the risk of anxiety or depression may increase in the mothers who selected exclusive formula feeding or short-term breastfeeding. Thus, an adequate support and counseling for these mothers should be provided. In addition to raising public awareness of HTLV-1 infection, epidemiological data from the nationwide program needs to be collected and analyzed. In most cases, infected children are asymptomatic, and it is necessary to clarify how these children should be followed medically.
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Affiliation(s)
| | - Tokuo Miyazawa
- Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan
| | - Akihiko Sekizawa
- Japan Association of Obstetricians and Gynecologists, Tokyo, Japan
| | | | | | - Hiroyuki Moriuchi
- Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yasuhito Nerome
- Faculty of Medicine, School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Kaoru Uchimaru
- Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - Toshiki Watanabe
- Future Center Initiative, and Research Hospital of the Institute of Medical Science, The University of Tokyo, Tokyo, Japan
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Umekita K, Okayama A. HTLV-1 Infection and Rheumatic Diseases. Front Microbiol 2020; 11:152. [PMID: 32117170 PMCID: PMC7025999 DOI: 10.3389/fmicb.2020.00152] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 01/22/2020] [Indexed: 01/18/2023] Open
Abstract
Some major research and clinical questions about human T-cell leukemia virus type 1 (HTLV-1) infection and rheumatic diseases remain: (1) Does HTLV-1 infection cause rheumatic diseases? (2) Do patients with rheumatic diseases display different responses to treatment with anti-rheumatic agents when they are HTLV-1 carriers? (3) Is adult T-cell leukemia/lymphoma (ATL) or HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) more prevalent in HTLV-1 carriers with rheumatic diseases who are treated with anti-rheumatic agents? These questions are important because increasing numbers of patients with rheumatic diseases are currently receiving treatment with aggressive medicines such as immunosuppressants and biologics. Studies on HTLV-1 gene-transgenic mice have shown manifestations resembling rheumatic diseases. Epidemiological studies have shown a high incidence of HTLV-1 infection in patients with rheumatic diseases including rheumatoid arthritis (RA), Sjogren’s syndrome, and polymyositis. HTLV-1-positive and HTLV-1-negative patients with RA have displayed similar immunological features including the seroprevalence of anti-citrullinated peptide antibodies. Conversely, attenuated effectiveness of tumor necrosis factor inhibitors for HTLV-1-positive patients with RA in Japan has been reported. Therefore, although no direct evidence has shown that HTLV-1 infection alone causes rheumatic diseases, HTLV-1 may affect the inflammation of RA. Although the incidence of ATL or HAM/TSP among patients with rheumatic diseases has not been investigated in large-scale studies, ATL or HAM/TSP has developed among HTLV-1-positive patients with rheumatic diseases. HTLV-1 infection may affect the clinical course of patients with rheumatic diseases, particularly after receiving anti-rheumatic agents. Because studies on these issues are limited, further investigation with large sample sizes is necessary.
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Affiliation(s)
- Kunihiko Umekita
- Department of Rheumatology, Infectious Diseases, and Laboratory Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Akihiko Okayama
- Department of Rheumatology, Infectious Diseases, and Laboratory Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
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